Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Division of Rheumatology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
Exp Dermatol. 2024 Oct;33(10):e15194. doi: 10.1111/exd.15194.
Hidradenitis Suppurativa (HS) is a chronic, debilitating, auto-inflammatory condition often associated with inflammatory arthritis, significantly impacting patients' quality of life. Early diagnosis of both conditions is crucial for optimal management. The objective of this study was to determine the prevalence and factors associated with the development of inflammatory arthritis among HS patients. A cross-sectional study was conducted between November 2021 and February 2023 at an academic dermatology centre in Canada. Adult patients with HS were consecutively sampled, and 52 patients consented to participate and completed assessments. Variables examined included age, sex, HS severity, treatment, ethnicity, family history, lifestyle factors and comorbidities. The main outcomes were rheumatologist-confirmed inflammatory arthritis diagnosis and associated risk factors. Among 52 patients (24 males, 28 females; mean age: 37.4 years), 12 had inflammatory arthritis. Multivariate analysis revealed that Blacks (OR = 0.10, p < 0.001, CI: 0.026-0.343) and Asians (OR = 0.02, p < 0.001, CI: 0.005-0.109) had lower inflammatory arthritis odds compared to Whites. Every 1-year increase in age at HS onset correlated with a 1.17-fold increase in the odds of developing inflammatory arthritis (OR: 1.17, p < 0.001, CI: 1.12-1.24). Smoking (OR = 0.01, p < 0.001, CI: 0.002-0.49), hypertension (OR: 0.23, p = 0.04, CI: 0.057-0.930) and depression (OR: 0.12, p < 0.001, CI: 0.041-0.330) reduced inflammatory arthritis odds. White ethnicity and older age at HS onset were positively associated with inflammatory arthritis, while smoking, hypertension and depression were negatively associated. These findings suggest a distinct subset of HS patients with inflammatory arthritis that warrant further prospective studies. This study contributes to the understanding of inflammatory arthritis in HS patients and emphasises the importance of rheumatology referral during dermatologic clinic visits.
化脓性汗腺炎（HS）是一种慢性、使人虚弱的自身炎症性疾病，常与炎症性关节炎相关，显著影响患者的生活质量。这两种疾病的早期诊断对优化管理至关重要。本研究旨在确定 HS 患者中炎症性关节炎的患病率和相关因素。这是一项在加拿大一所学术皮肤科中心进行的横断面研究，于 2021 年 11 月至 2023 年 2 月间进行。连续抽取 HS 成年患者进行采样，52 名患者同意参与并完成评估。检查的变量包括年龄、性别、HS 严重程度、治疗方法、种族、家族史、生活方式因素和合并症。主要结局是风湿科医生确诊的炎症性关节炎诊断和相关危险因素。在 52 名患者（24 名男性，28 名女性；平均年龄：37.4 岁）中，有 12 名患有炎症性关节炎。多变量分析显示，与白人相比，黑人（OR=0.10，p<0.001，CI：0.026-0.343）和亚洲人（OR=0.02，p<0.001，CI：0.005-0.109）发生炎症性关节炎的几率较低。HS 发病年龄每增加 1 岁，发生炎症性关节炎的几率就会增加 1.17 倍（OR：1.17，p<0.001，CI：1.12-1.24）。吸烟（OR=0.01，p<0.001，CI：0.002-0.49）、高血压（OR：0.23，p=0.04，CI：0.057-0.930）和抑郁症（OR：0.12，p<0.001，CI：0.041-0.330）降低了炎症性关节炎的几率。白人种族和 HS 发病年龄较大与炎症性关节炎呈正相关，而吸烟、高血压和抑郁症则呈负相关。这些发现表明存在具有炎症性关节炎的特定 HS 患者亚群，这需要进一步的前瞻性研究。本研究有助于了解 HS 患者的炎症性关节炎，并强调在皮肤科就诊期间进行风湿病转诊的重要性。
