Immune Inflammatory Markers May Indicate Cardiovascular Risk in Hidradenitis Suppurativa

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A possible link between hidradenitis suppurativa and cardiovascular risk is investigated.

Investigators at St Vincent’s University Hospital in Ireland reacted to a recently published article about systemic immune inflammation in hidradenitis suppurativa (HS) in a letter to the editor published in the Journal of the European Academy of Dermatology and Venereology.

The original study was a retrospective analysis comparing immune markers of inflammation between healthy control individuals (n=35) and patients with HS (n=142). The study found that increased systemic immune-inflammation index (SIII) and pan immune-inflammation value (PIV) were markers of HS severity.

The letter authors noted that the relationship between these markers and cardiovascular disease (CVD) should also be taken into consideration, as previous studies have found that SIII greater than 620 was associated with myocardial ischemia with a sensitivity of 78.4% and specificity of 64%.

The letter authors performed a retrospective study comparing biomarkers of inflammation from 100 patients with HS with 100 patients with psoriasis.

The HS and psoriasis cohorts comprised 38% and 79% women, mean age 47.4 (standard deviation [SD], 15.53) and 38.6 (SD, 10.07) years, 35.6% and 48.9% were smokers, 3% and 12% had hypertension, 8% and 11% had dyslipidemia, 7% and 5% had diabetes, and 25% and 84% were being treated with biologic therapies, respectively.

The HS cohort was associated with significantly higher neutrophils (mean, 5.44 vs 4.62 x 109/L; P =.006), platelets (mean, 300.32 vs 273.19 x 109/L; P =.006), lymphocytes (mean, 2.41 vs 2.07 ´109/L; P =.004), and C-reactive protein (mean, 6.9 vs 4.05 mg/L; P =.002) levels but not SIII (mean, 742.5 vs 696.45; P =.447).

Stratified by the presence of cardiovascular (CV) comorbidities, SIII was higher among patients with CV comorbidities and psoriasis (mean, 9.36.16 vs 636.52; P =.006) but not CV comorbidities and HS (mean, 8.41.12 vs 723.72; P =.299), respectively.

SIII was not correlated with Psoriasis Area Severity Index (r, 0.11; P =.266) or Hurley stage (r, -0.05; P =.648).

This analysis may have been limited by the HS study population which was younger and included more women as they  should be at lower risk for CVD in general.

The letter authors agreed with the study findings that SIII may be a novel biomarker for inflammation in HS but did not replicate its association with HS severity, as measured by Hurley stage. The letter authors concluded that SIII should be further evaluated in HS.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Kearney N, McCourt C, Hughes R, Alsharqi A, O’Kane D, Kirby B. Systemic immune inflammation index is a marker of cardiovascular risk and not just disease severity in hidradenitis suppurativa. J Eur Acad Dermatol Venereol. Published online June 13, 2022. doi:10.1111/jdv.18322