Because hidradenitis suppurativa (HS) has a strong association with polycystic ovary syndrome (PCOS), women with HS who have signs or symptoms of hyperandrogenism should be screened for PCOS, according to the results of a cross-sectional analysis published in the Journal of Investigative Dermatology.

The investigators sought to determine the prevalence of PCOS among women with HS and the strength of the association. They identified a total of 22,990 female patients with HS.

There was a statistically significant prevalence of PCOS of 9.0% (2070 of 22,990) among women with HS compared with 2.9% (96,940 of 3,369,150) among those in the general population (P <.0001). The prevalence of PCOS was highest in women with HS who had diabetes (17.2%), were obese (11.0%), and were between 30 and 39 years of age (11.0%).

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Based on an unadjusted analysis, patients with HS had 3.34 times the odds of having PCOS as did patients without HS (95% CI, 3.19-3.50). After controlling for race, age, obesity, smoking status, and presence of type 2 diabetes, the odds of having PCOS was 2.14 times as high in patients with HS vs those without the disorder (95% CI, 2.04-2.24). The strength of the association between HS and PCOS was similar to that of diabetes and obesity with PCOS (odds ratio [OR] 2.88; 95% CI, 2.83-2.93 and OR 3.93; 95% CI, 3.87-3.99, respectively).

Notably, the strength of the association between HS and PCOS differed significantly based on age group (P <.0001), race (P =.0011), presence of diabetes (P =.02), and smoking status (P =.0003).

The greatest relative difference in the odds of having PCOS between those with and without HS was reported among patients 18 to 29 years of age (OR 2.50; 95% CI, 2.30-2.71), nonsmokers (OR 2.37; 95% CI, 2.21-2.55), white patients (OR 2.26; 95% CI, 2.14-1.40), and women without diabetes (OR 2.22; 95% CI, 2.10-2.34).

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The researchers concluded that based on the strong relationship demonstrated between PCOS and HS, women with HS and symptoms or signs of excessive androgen should undergo PCOS screening. The role played by androgens in HS and the potential benefit of anti-androgen treatment in these patients warrants additional investigation.


Garg A, Neuren E, Strunk A. Hidradenitis suppurativa is associated with polycystic ovary syndrome: a population-based analysis in the United States [published online January 26, 2018]. J Invest Dermatol. doi: 10.1016/j.jid.2018.01.009