Bidirectional Risk Association Between Hidradenitis Suppurativa and Inflammatory Bowel Disease

Louise Lönndahl; Maria Najeeb; Hassan Killasli; Lennart Emtestam; Ralf J. Ludwig; Philip Curman

doi:10.2340/actadv.v105.43657

Bidirectional Risk Association Between Hidradenitis Suppurativa and Inflammatory Bowel Disease

Louise Lönndahl, Maria Najeeb, Hassan Killasli, Lennart Emtestam, Ralf J. Ludwig, Philip Curman^*

^*Korrespondierende/r Autor/-in für diese Arbeit

Karolinska Institutet

3 Zitate (Scopus)

Abstract

Hidradenitis suppurativa is an inflammatory skin disease of the pilosebaceous unit encompassing painful, recurrent, and malodorous abscesses, inflammatory nodules, dermal sinus tracts, and cicatrices. Hidrade-nitis suppurativa has been linked to several comorbi-dities, including inflammatory bowel disease, though evidence is limited by small sample sizes and pos-sible bidirectional associations remain uncertain. A large-scale, propensity-score matched retrospective cohort study was performed using the TriNetX platform to investigate bidirectional risks between hidra-denitis suppurativa and inflammatory bowel disease. Data included over 200,000 hidradenitis suppurativa patients and 3.3 million inflammatory bowel disease patients. Hidradenitis suppurativa was associated with a 36% increased risk of developing any inflammatory bowel disease diagnosis within 5 years of diagnosis (hazard ratio [HR] 1.356, confidence interval [CI] 1.313–1.401), with the highest risk of Crohn’s disease (HR 2.501, CI 2.209–2.832), followed by ulcerative colitis (UC) (HR 1.722, CI 1.536–1.930), and other/ unspecified inflammatory bowel disease (HR 1.349, CI 1.306–1.394). Conversely, individuals with any inflammatory bowel disease diagnosis had a 31% increased risk of developing hidradenitis suppurativa (HR 1.313, CI 1.274–1.353), with Crohn’s disease showing the strongest association (HR 2.441, CI 2.242–2.658), followed by UC (HR 1.493, CI 1.358–1.642). These findings highlight the bidirectional risk relationship between hidradenitis suppurativa and inflammatory bowel disease, demonstrating that the likelihood of developing either condition is significantly elevated in patients already diagnosed with the other.

Originalsprache	Englisch
Aufsatznummer	adv43657
Zeitschrift	Acta Dermato-Venereologica
Jahrgang	105
ISSN	0001-5555
DOIs	https://doi.org/10.2340/actadv.v105.43657
Publikationsstatus	Veröffentlicht - 2025

Fördermittel

Ethics declarations: TriNetX data are presented in aggregated form and solely contain anonymized data following the de-identification standard as defined by the US Health Insurance Portability and Accountability Act (HIPAA) in section §164,514(a). TriNetX is certified to the ISO 27001:2013 standard and maintains a so-called Information Security Management System to ensure rigorous protection of the healthcare data it has access to, compliant with the HIPAA Security Rule. The use of TriNetX in research has been approved by the Swedish Ethical Review Authority (diary number 2024-06878-02). Funding information: PC was supported by Region Stockholm, Tore Nilson Foundation, and Karolinska Institutet. RJL was supported by the Cluster of Excellence Precision Medicine in Chronic Inflammation (EXC 2167), Individual Research Grant LU 877/25-1, funded by the Deutsche Forschungsgemeinschaft and the Schleswig-Holstein Excellence-Chair Program from the State of Schleswig-Holstein. Data availability statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. Conflicts of interest: LL has received consultancy fees and registration fees from LEO Pharma for conferences, and a consultancy fee from Sanofi, UCB, and Novartis for expert meetings. HK has received consultancy fees from Novartis and UCB for expert meetings. RJL has received travel funding from TriNetX and is a consultant for QIMA Monasterium. All other authors report no conflicts of interest.

Träger	Trägernummer
Schleswig-Holstein
Deutsche Forschungsgemeinschaft
Stockholm Region
Tore Nilsons Stiftelse för Medicinsk Forskning
Karolinska Institutet	LU 877/25-1

UN SDGs

Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

SDG 3 – Gesundheit und Wohlergehen

Strategische Forschungsbereiche und Zentren

Forschungsschwerpunkt: Infektion und Entzündung - Zentrum für Infektions- und Entzündungsforschung Lübeck (ZIEL)
Zentren: Center for Research on Inflammation of the Skin (CRIS)

DFG-Fachsystematik

2.21-05 Immunologie
2.22-19 Dermatologie
2.22-15 Gastroenterologie

Dokumente

10.2340/actadv.v105.43657

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title = "Bidirectional Risk Association Between Hidradenitis Suppurativa and Inflammatory Bowel Disease",

abstract = "Hidradenitis suppurativa is an inflammatory skin disease of the pilosebaceous unit encompassing painful, recurrent, and malodorous abscesses, inflammatory nodules, dermal sinus tracts, and cicatrices. Hidrade-nitis suppurativa has been linked to several comorbi-dities, including inflammatory bowel disease, though evidence is limited by small sample sizes and pos-sible bidirectional associations remain uncertain. A large-scale, propensity-score matched retrospective cohort study was performed using the TriNetX platform to investigate bidirectional risks between hidra-denitis suppurativa and inflammatory bowel disease. Data included over 200,000 hidradenitis suppurativa patients and 3.3 million inflammatory bowel disease patients. Hidradenitis suppurativa was associated with a 36\% increased risk of developing any inflammatory bowel disease diagnosis within 5 years of diagnosis (hazard ratio [HR] 1.356, confidence interval [CI] 1.313–1.401), with the highest risk of Crohn{\textquoteright}s disease (HR 2.501, CI 2.209–2.832), followed by ulcerative colitis (UC) (HR 1.722, CI 1.536–1.930), and other/ unspecified inflammatory bowel disease (HR 1.349, CI 1.306–1.394). Conversely, individuals with any inflammatory bowel disease diagnosis had a 31\% increased risk of developing hidradenitis suppurativa (HR 1.313, CI 1.274–1.353), with Crohn{\textquoteright}s disease showing the strongest association (HR 2.441, CI 2.242–2.658), followed by UC (HR 1.493, CI 1.358–1.642). These findings highlight the bidirectional risk relationship between hidradenitis suppurativa and inflammatory bowel disease, demonstrating that the likelihood of developing either condition is significantly elevated in patients already diagnosed with the other.",

author = "Louise L{\"o}nndahl and Maria Najeeb and Hassan Killasli and Lennart Emtestam and Ludwig, \{Ralf J.\} and Philip Curman",

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year = "2025",

doi = "10.2340/actadv.v105.43657",

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journal = "Acta Dermato-Venereologica",

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AU - Lönndahl, Louise

AU - Najeeb, Maria

AU - Killasli, Hassan

AU - Emtestam, Lennart

AU - Ludwig, Ralf J.

AU - Curman, Philip

PY - 2025

Y1 - 2025

N2 - Hidradenitis suppurativa is an inflammatory skin disease of the pilosebaceous unit encompassing painful, recurrent, and malodorous abscesses, inflammatory nodules, dermal sinus tracts, and cicatrices. Hidrade-nitis suppurativa has been linked to several comorbi-dities, including inflammatory bowel disease, though evidence is limited by small sample sizes and pos-sible bidirectional associations remain uncertain. A large-scale, propensity-score matched retrospective cohort study was performed using the TriNetX platform to investigate bidirectional risks between hidra-denitis suppurativa and inflammatory bowel disease. Data included over 200,000 hidradenitis suppurativa patients and 3.3 million inflammatory bowel disease patients. Hidradenitis suppurativa was associated with a 36% increased risk of developing any inflammatory bowel disease diagnosis within 5 years of diagnosis (hazard ratio [HR] 1.356, confidence interval [CI] 1.313–1.401), with the highest risk of Crohn’s disease (HR 2.501, CI 2.209–2.832), followed by ulcerative colitis (UC) (HR 1.722, CI 1.536–1.930), and other/ unspecified inflammatory bowel disease (HR 1.349, CI 1.306–1.394). Conversely, individuals with any inflammatory bowel disease diagnosis had a 31% increased risk of developing hidradenitis suppurativa (HR 1.313, CI 1.274–1.353), with Crohn’s disease showing the strongest association (HR 2.441, CI 2.242–2.658), followed by UC (HR 1.493, CI 1.358–1.642). These findings highlight the bidirectional risk relationship between hidradenitis suppurativa and inflammatory bowel disease, demonstrating that the likelihood of developing either condition is significantly elevated in patients already diagnosed with the other.

AB - Hidradenitis suppurativa is an inflammatory skin disease of the pilosebaceous unit encompassing painful, recurrent, and malodorous abscesses, inflammatory nodules, dermal sinus tracts, and cicatrices. Hidrade-nitis suppurativa has been linked to several comorbi-dities, including inflammatory bowel disease, though evidence is limited by small sample sizes and pos-sible bidirectional associations remain uncertain. A large-scale, propensity-score matched retrospective cohort study was performed using the TriNetX platform to investigate bidirectional risks between hidra-denitis suppurativa and inflammatory bowel disease. Data included over 200,000 hidradenitis suppurativa patients and 3.3 million inflammatory bowel disease patients. Hidradenitis suppurativa was associated with a 36% increased risk of developing any inflammatory bowel disease diagnosis within 5 years of diagnosis (hazard ratio [HR] 1.356, confidence interval [CI] 1.313–1.401), with the highest risk of Crohn’s disease (HR 2.501, CI 2.209–2.832), followed by ulcerative colitis (UC) (HR 1.722, CI 1.536–1.930), and other/ unspecified inflammatory bowel disease (HR 1.349, CI 1.306–1.394). Conversely, individuals with any inflammatory bowel disease diagnosis had a 31% increased risk of developing hidradenitis suppurativa (HR 1.313, CI 1.274–1.353), with Crohn’s disease showing the strongest association (HR 2.441, CI 2.242–2.658), followed by UC (HR 1.493, CI 1.358–1.642). These findings highlight the bidirectional risk relationship between hidradenitis suppurativa and inflammatory bowel disease, demonstrating that the likelihood of developing either condition is significantly elevated in patients already diagnosed with the other.

UR - https://www.scopus.com/pages/publications/105010473511

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DO - 10.2340/actadv.v105.43657

M3 - Journal articles

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AN - SCOPUS:105010473511

SN - 0001-5555

VL - 105

JO - Acta Dermato-Venereologica

JF - Acta Dermato-Venereologica

M1 - adv43657

ER -

Bidirectional Risk Association Between Hidradenitis Suppurativa and Inflammatory Bowel Disease

Abstract

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DFG-Fachsystematik

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