Ocular Comorbidities Prevalent Among Patients with Hidradenitis Suppurativa

By Alexa Josaphouitch, /alert Contributor

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According to a new study in JAMA Dermatology, patients with hidradenitis suppurativa have greater rates and increased burden of ocular comorbidities. Hidradenitis suppurativa (HS) is a chronic systemic inflammatory disorder of the terminal follicular epithelium in the apocrine gland-bearing skin. 

“These data suggest that, while uncommon, a brief assessment of ocular history and symptoms during routine visits could help identify patients with HS who should see an ophthalmologist,” Rosalynn R. Z. Conic, MD, PhD, University of Maryland, and her colleagues wrote.

This case-control study compared ocular comorbidities in patients with HS and controls using data from Explorys. This large, cloud-based aggregate database contains demographic, clinical, laboratory, and treatment information on 72 million unique patients across 369 hospitals in the US. Patients with HS were identified using the term hidradenitis suppurativa and ocular comorbidities were identified using the terms anterior uveitis, posterior uveitis, chronic uveitis, uveitis, scleritis, episcleritis, interstitial keratitis, and conjunctivitis. 

The study excluded those with other autoimmune diseases known to increase the risk of ocular comorbidities, such as psoriasis, ankylosing spondylitis, rheumatoid arthritis, Bechet syndrome, Crohn disease, ulcerative colitis, systemic lupus erythematosus, Marfan syndrome, Down syndrome, Ehlers-Danlos syndrome, diabetes, and HIV.

Of the 31,400 patients with HS, 13.89% (4,360 patients) had ocular comorbidities. In the control group, 3.2% had ocular comorbidities (1,654,320 of 51,517,730). The majority of patients with HS were women and 58.8% were Caucasian.

Anterior uveitis was present in 0.6% of patients with HS versus 0.1% of patients in the control group. Chronic uveitis was present in 20 patients with HS (0.1%) and 6,170 controls (0.01%) (OR, 1.07; 95% CI, 0.65-1.48; P = .21). Posterior uveitis was present in 20 patients with HS (0.1%) and 6,380 controls (0.01%) (OR, 1.25; 95% CI, 0.83-1.66; P = .21).

The OR of episcleritis was significantly increased among patients with HS. The ORs of keratitis (HS, 0.9% vs controls, 0.2%) and conjunctivitis (11.9% vs 2.9%) were increased among those with HS. The ORs of scleritis (HS, 0.3% vs controls, 0.03%) and interstitial keratitis (HS, 0.1% vs controls, 0.01%) were not.

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