Patients with Hidradenitis Suppurativa Have Increased Odds of Respiratory Disease, According to Study Findings

Patients with hidradenitis suppurativa (HS) have increased adjusted odds of respiratory diseases, including asthma and sleep apnea, according to a study published in the International Journal of Dermatology.¹

Despite the considerable morbidity and mortality associated with respiratory disorders, they are often overlooked in the context of HS,according to researchers Almuhanna et al. Given the shared inflammatory pathways and comorbidities between HS and respiratory diseases, they hypothesized that patients with HS patients may be at an increased risk of developing various pulmonary disorders.²

However, large-scale population-based studies examining this relationship are scarce. With this in mind, researchers aimed to explore the associations between HS and respiratory conditions, hypothesizing that patients with HS are more likely to develop respiratory disorders, particularly those sharing risk factors or pathophysiological mechanisms with HS.

The cross-sectional case-control study utilized the National Inpatient Sample (NIS) database, containing data on millions of hospital stays in the United States. Patients with an International Classification of Diseases, Ninth Revision, Clinical Modification Code (ICD-9-CM) for HS from 2002 to 2012 were included.

Controls were randomly matched based on age and sex in a 1:4 ratio. The study investigated various respiratory conditions using corresponding ICD-9 codes, while controlling for confounders such as smoking and obesity.

The study included 23,767 hospital admissions for patients with HS matched with 95,068 controls. Patients with HS exhibited higher rates of asthma, chronic airway obstruction, sarcoidosis, and sleep apnea compared to controls.

After adjusting for confounders, the associations remained significant. Conversely, patients with HS were less likely to have pneumonia, chronic bronchitis, pleural effusion, and respiratory failure.

Inflammation, microbial dysbiosis, and common comorbidities like obesity and smoking may contribute to the associations between HS and respiratory disease, according to study authors.

Authors noted several potential limitations of the study, including its cross-sectional design, reliance on ICD-9 codes, and potential for unmeasured confounders. Additionally, the generalizability of the findings may be limited to hospitalized patients with HS and the study period from 2002 to 2012.

"Here, we report a significant association between HS and several common respiratory diseases, including asthma and sleep apnea. These respiratory conditions may further increase the morbidity of an already highly disabling disease," according to Almuhanna et al. "Physicians treating HS patients should be aware of and alert to these identified associations. Further studies must examine risk factors and temporal relationships between HS and respiratory disease."

References

1. Almuhanna N, Aljughayman M, Fidler L, Alhusayen R. Risk of respiratory diseases among hospitalized patients with hidradenitis suppurativa. Int J Dermatol. April 18, 2024. Accessed April 24, 2024. doi:10.1111/ijd.17182
2. Wertenteil S, Strunk A, Garg A. Incidence of obstructive sleep apnoea in patients with hidradenitis suppurativa: a retrospective population-based cohort analysis. Br J Dermatol. 2018. Accessed April 24, 2024. https://doi.org/10.1111/bjd.16931