Risk of Atopic Diseases in Patients with Hidradenitis Suppurativa

Background: Hidradenitis suppurativa (HS) and allergic diseases were considered to have different immune pathways involved. However, available evidences seemed to be inconsistent and the association was not well-developed yet. Objective: The aim of this study was to perform a systematic review and meta-analysis to evaluate the association between HS and atopic diseases, including asthma, atopic dermatitis, allergic rhinitis, and conjunctivitis. Methods: Search in databases including PubMed, Embase, and Web of Science was performed. Synonyms were determined based on MeSH terms and Emtree. Observational studies with proper comparative arm were selected. For quality evaluation of extracted studies, the Newcastle-Ottawa Scale was utilized. Odds ratio of atopic dermatitis, asthma, allergic rhinitis, and conjunctivitis were evaluated in HS patients (comparing with non-HS people). I2 value was applied to evaluate the heterogeneity within studies. Results: After appraising 1,654 studies, in total, 12 studies were selected for data extraction. In adjusted models, people with HS is significantly associated with higher risk of having asthma, with a pooled odds ratio of 1.50 (95% CI, 1.24-1.81). Risk of presenting atopic dermatitis in HS patients was also increased, with an odd ratio of 4.10 (95% CI, 2.16-8.18). The association remained its significance in sensitivity models. Evidences were insufficient to support the association between HS and allergic rhinitis and conjunctivitis. Conclusion: Current evidence supported that atopic dermatitis and asthma were associated with HS. Physicians should be aware of the reported association while caring people with HS and related screening of allergies comorbidities should be recommended.