Patients with hidradenitis suppurativa (HS) have a higher likelihood for substance use disorder (SUD) developing compared with those without the condition, with pain and poor disease-related quality of life likely associated with this risk, according to the results of a cross-sectional population analysis conducted in the United States and published in the Journal of the American Academy of Dermatology.

A total of 32,625 adult patients with HS were identified through data from electronic health records from a population-based sample of >50 million individuals. The prevalence of SUD was 4.0% (1315 of 32,625) in patients with HS, compared with 2.0% (195,260 of 9,581,640) in those without HS, which was statistically significant (P <.001). Among patients with HS, the most common forms of substance misuse were alcohol (1.9%), opioids (1.3%), and cannabis (1.2%).

When comparing individuals with HS and those without the disorder, patients with HS had 1.50 times the adjusted odds (95% CI, 1.42-1.59; P <.0001) of SUD. Moreover, those with HS had a significantly greater risk for SUD across demographic subgroups including age, gender, race, comorbidities (ie, depression and anxiety disorder), and insurance status. The link between HS and SUD was generally stronger in patients 45 to 64 years of age, nonwhites, those with private insurance, and those who did not experience depression or anxiety disorder.

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A major limitation of the current study is that often SUD may not be diagnosed appropriately.

The investigators concluded that because patients with HS have a higher risk for SUD, periodic screening for substance abuse may be beneficial in this population.

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Garg A, Papagermanos V, Midura M, Strunk A, Merson J. Opioid, alcohol, and cannabis misuse among patients with hidradenitis suppurativa: a population-based analysis in the United States [published online February 27, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.02.053