School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan.
Front Immunol. 2022 Dec 1;13:1033844. doi: 10.3389/fimmu.2022.1033844. eCollection 2022.
Hidradenitis suppurativa were associated with comorbidities in various organ systems. Inflammatory dermatological diseases such as pyoderma gangrenosum were reported to be associated with hidradenitis suppurativa. Nevertheless, as for the association between hidradenitis suppurativa and psoriasis, evidences were insufficient. In many studies, the association between psoriasis and hidradenitis suppurativa has been reported. However, some evidence seems to be controversial. The purpose of the systematic review and meta-analysis was to assess whether there was significant association between HS and psoriasis.
On June 01, 2022, we appraised 2,795 articles from databases including PubMed, Web of Science and Embase. Search syntaxes were based on 'hidradenitis suppurativa' or 'acne inversa' with "psoriasis", "comorbidities" or 'epidemiology'. Synonyms were determined based on MeSH terms and Emtree. Observational results that evaluated the odds ratio for people with hidradenitis suppurativa who had psoriasis were extracted for qualitative synthesis.
After the selection process of the initial 2,795 studies, ten observational studies, including 3 cohort studies, 1 case-control study, and 6 cross-sectional studies, were extracted for critical appraisal. Based on the integration of 7 studies (with more than 560,000 participants included), people with hidradenitis suppurativa had a higher risk of having psoriasis, with a 2.67-fold risk (95% CI, 1.84, 3.87). The association remained in the sensitivity analyses utilizing strict adjustment models. In the analysis that only included studies with a similar study design and adjustments in obesity-related factors, the risk of people with hidradenitis suppurativa having psoriasis was 3.24 (95% CI, 2.27, 4.62). In male patients with HS, the risk of having psoriasis was 4.30-fold higher than male patients without HS (95% CI, 2.37, 7.78). Likewise, in an analysis including 3 cross-sectional studies, the risk of female HS patients having psoriasis was 3.94-fold higher than female HS-free patients (95% CI, 2.34, 6.63).
The co-occurrence of hidradenitis suppurativa and psoriasis can greatly increase the burden of the disease. Psoriasis could be one of the critical comorbidities of hidradenitis suppurativa and should be recommended for future screening and follow up. The association between the two diseases should be kept in mind in managing hidradenitis suppurativa patients. More prospective studies are needed to establish the true magnitude of the association between psoriasis and hidradenitis suppurativa.
化脓性汗腺炎与各种器官系统的合并症有关。有报道称，化脓性汗腺炎等炎症性皮肤病与银屑病有关。然而，关于化脓性汗腺炎和银屑病之间的关联，证据不足。在许多研究中，已经报道了银屑病和化脓性汗腺炎之间的关联。然而，一些证据似乎存在争议。本系统评价和荟萃分析的目的是评估 HS 和银屑病之间是否存在显著关联。
2022 年 6 月 1 日，我们从包括 PubMed、Web of Science 和 Embase 在内的数据库中评估了 2795 篇文章。搜索语法基于“化脓性汗腺炎”或“反向痤疮”和“银屑病”、“合并症”或“流行病学”。同义词是根据 MeSH 术语和 Emtree 确定的。提取了评估化脓性汗腺炎患者银屑病的比值比的观察性结果，进行定性综合。
在对最初的 2795 项研究进行筛选过程后，从 10 项观察性研究中提取了 10 项研究进行批判性评价，其中包括 3 项队列研究、1 项病例对照研究和 6 项横断面研究。基于对 7 项研究（包括超过 560,000 名参与者）的综合分析，化脓性汗腺炎患者患银屑病的风险更高，风险比为 2.67（95%CI，1.84,3.87）。在使用严格调整模型的敏感性分析中，这种关联仍然存在。在仅包括具有相似研究设计和肥胖相关因素调整的研究的分析中，化脓性汗腺炎患者患银屑病的风险为 3.24（95%CI，2.27,4.62）。在男性化脓性汗腺炎患者中，患银屑病的风险是没有化脓性汗腺炎的男性患者的 4.30 倍（95%CI，2.37,7.78）。同样，在包括 3 项横断面研究的分析中，女性化脓性汗腺炎患者患银屑病的风险是女性无化脓性汗腺炎患者的 3.94 倍（95%CI，2.34,6.63）。
化脓性汗腺炎和银屑病的同时发生会大大增加疾病负担。银屑病可能是化脓性汗腺炎的关键合并症之一，应建议进行未来的筛查和随访。在管理化脓性汗腺炎患者时，应牢记这两种疾病之间的关联。需要更多的前瞻性研究来确定银屑病和化脓性汗腺炎之间关联的真实程度。
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