Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations

Amit Garg, Neeta Malviya, Andrew Strunk, Shari Wright, Afsaneh Alavi, Raed Alhusayen, Ali Alikhan, Steven D. Daveluy, Isabelle Delorme, Noah Goldfarb, Wayne Gulliver, Iltefat Hamzavi, Tarannum Jaleel, Alexa B. Kimball, Joslyn S. Kirby, Mark G. Kirchhof, Janice Lester, Hadar Lev-Tov, Michelle A. Lowes, Robert MichelettiLauren A. Orenstein, Vincent Piguet, Christopher Sayed, Jerry Tan, Haley B. Naik

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Hidradenitis suppurativa (HS) is associated with comorbidities that contribute to poor health, impaired life quality, and mortality risk. Objective: To provide evidence-based screening recommendations for comorbidities linked to HS. Methods: Systematic reviews were performed to summarize evidence on the prevalence and incidence of 30 comorbidities in patients with HS relative to the general population. The screening recommendation for each comorbidity was informed by the consistency and quality of existing studies, disease prevalence, and magnitude of association, as well as benefits, harms, and feasibility of screening. The level of evidence and strength of corresponding screening recommendation were graded by using the Strength of Recommendation Taxonomy (SORT) criteria. Results: Screening is recommended for the following comorbidities: acne, dissecting cellulitis of the scalp, pilonidal disease, pyoderma gangrenosum, depression, generalized anxiety disorder, suicide, smoking, substance use disorder, polycystic ovary syndrome, obesity, dyslipidemia, diabetes mellitus, metabolic syndrome, hypertension, cardiovascular disease, inflammatory bowel disease, spondyloarthritis, and sexual dysfunction. It is also recommended to screen patients with Down syndrome for HS. The decision to screen for specific comorbidities may vary with patient risk factors. The role of the dermatologist in screening varies according to comorbidity. Limitations: Screening recommendations represent one component of a comprehensive care strategy. Conclusions: Dermatologists should support screening efforts to identify comorbid conditions in HS.

Original languageEnglish (US)
JournalJournal of the American Academy of Dermatology
Early online dateJan 23 2021
DOIs
StateE-pub ahead of print - Jan 23 2021
Externally publishedYes

Bibliographical note

Funding Information:
Funding sources: Dr Orenstein is supported in part by Building Interdisciplinary Research Careers in Women's Health of the National Institutes of Health (K12D085850). Dr Naik is supported in part by the National Institutes of Health (NIAMS K32 AR074531).

Publisher Copyright:
© 2021 American Academy of Dermatology, Inc.

Keywords

  • Crohn's disease
  • North America
  • acne
  • cardiovascular disease
  • comorbidity
  • depression
  • dermatologist
  • diabetes mellitus
  • dissecting cellulitis of the scalp
  • down syndrome
  • dyslipidemia
  • generalized anxiety disorder
  • guidelines
  • herpes zoster
  • hidradenitis suppurativa
  • hypertension
  • inflammatory bowel disease
  • lymphoma
  • metabolic syndrome
  • obesity
  • pilonidal disease
  • polycystic ovary syndrome
  • pyoderma gangrenosum
  • screening
  • sexual dysfunction
  • smoking
  • spondyloarthritis
  • substance use
  • suicide
  • systemic
  • ulcerative colitis

PubMed: MeSH publication types

  • Journal Article
  • Review

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