The inflammatory skin disease hidradenitis suppurativa is associated with significantly increased risks of adverse cardiovascular outcomes such as ischemic stroke, myocardial infarction, and cardiovascular mortality, according to results of a population-based study.

A population-based cohort study of 5,964 patients with hidradenitis suppurativa showed that, after adjusting for confounders such as age, sex, smoking, and other comorbidities, hidradenitis suppurativa was associated with a 57% greater risk of myocardial infarction, 33% greater risk of ischemic stroke, 53% increase in major adverse cardiovascular events, and 35% increase in all-cause mortality over a mean 7.1 years of follow-up.

The study, published online Feb. 17 in JAMA Dermatology, also showed a significant increase in cardiovascular-associated death, which was the only adverse outcome that remained significantly elevated (incidence rate ratio, 1.58) in patients with hidradenitis suppurativa when compared with a control group of individuals with severe psoriasis ( JAMA Dermatol. 2016 Feb 17. doi: 10.1001/jamadermatol.2015.6264 ).

“Studies have suggested that, in hidradenitis suppurativa, atrophy of the sebaceous glands, follicular hyperkeratinization, and subsequent hair follicle destruction are associated with deep-seated inflammation, increased susceptibility to secondary infections, and chronic perpetuation of the inflammatory response,” wrote Dr. Alexander Egeberg of the University of Copenhagen and coauthors.

The researchers suggested that there was a “conspicuous absence” of research reports on the risk of cardiovascular disease in hidradenitis suppurativa, especially in light of accumulating evidence of the association between cardiovascular disease and other chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel disease.

No conflicts of interest were declared.


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