Patients with hidradenitis suppurativa (HS) are at an increased risk for the development of Crohn disease (CD), suggesting that those with HS who have signs or symptoms indicative of CD warrant additional evaluation by a gastroenterologist, according to the results of a cross-sectional analysis conducted in the United States and published in JAMA Dermatology.

The investigators sought to explore the prevalence of CD among patients with HS and to determine the strength of the association between the 2 conditions. A total of 51,340 patients with HS were identified using electronic health records data. Of these individuals, 35,000 were women; 56.5% of the cohort were aged 18 to 44 years, 34.2% were 45 to 64 years old, and 9.3% were ≥65 years.

The prevalence of CD among patients with HS was significantly higher than among those without CD (2.0% [1025 of 51,340] vs 0.6% [113,360 of 18,404,260], respectively; P <.001). The prevalence of CD was highest among patients with HS who were white (2.3%), were in the 45- to 64-year-old age range (2.4%), were not obese (2.8%), and were tobacco smokers (2.3%).

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Per univariable and multivariable analyses, patients with HS had 3.29 (95% CI, 3.09-3.50) and 3.05 (95% CI, 2.87-3.25) times the odds of having CD, respectively, when compared with those without HS. In fact, CD was linked to HS across all patient subgroups evaluated. The relationship between HS and CD was strongest among men (odds ratio [OR], 3.61; 95% CI, 3.24-4.03), those who were 45 to 64 years of age (OR, 3.49; 95% CI, 3.16-3.85), those who were not obese (OR, 4.09; 95% CI, 3.69-4.54), and nonsmokers (OR, 3.44; 95% CI, 3.10-3.82).

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The investigators concluded that dermatologists and gastroenterologists should be aware of the association between the 2 conditions to identify patients with HS and CD early in the course of disease, and thus optimize treatment, minimize complications, and avoid unnecessary procedures or therapies.


Garg A, Hundal J, Strunk A. Overall and subgroup prevalence of Crohn disease among patients with hidradenitis suppurativa: a population-based analysis in the United States [published online May 23, 2018]. JAMA Dermatol. doi: 10.1001/jamadermatol.2018.0878