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Hidradenitis Suppurativa and Crohn's Disease: A Case Series
S Kirthi1,2, R Hellen1, R O'Connor1
1Department of Dermatology, The Adelaide and Meath Hospital, Dublin.
Insights
This study identified an Irish cohort with Hidradenitis Suppurativa (HS) and Crohn's Disease (CD). Combined HS and CD patients often smoked and had increased BMI, but TNF-alpha inhibitors improved HS outcomes.
Area of Science:
- Dermatology
- Gastroenterology
- Immunology
Background:
- Hidradenitis Suppurativa (HS) presents with chronic abscesses and sinus tracts.
- Cutaneous Crohn's Disease (CD) can mimic HS symptoms.
- Understanding the overlap between HS and CD is crucial for diagnosis and management.
Purpose of the Study:
- To identify and characterize an Irish cohort with co-occurring HS and CD.
- To better recognize clinical manifestations of combined HS and CD.
- To gain insights into the pathophysiology of these overlapping conditions.
Main Methods:
- Retrospective review of patients diagnosed with HS and CD between 1990-2014 at Tallaght Hospital.
- Utilized HIPE Code for case identification.
- Analyzed demographic, clinical, and treatment data.
Main Results:
- Seven patients with both HS and CD were identified (5/7 female).
- The median age at diagnosis for both conditions was 37 years, with CD preceding HS.
- All patients smoked, 6 had increased BMI, and 43% had other autoimmune conditions.
- TNF-alpha inhibitor treatment for HS led to reduced flare-ups and clinical activity in 5/6 patients.
Conclusions:
- Combined HS and CD is observed in an Irish population, with specific demographic and risk factor profiles.
- CD diagnosis consistently preceded HS diagnosis in this cohort.
- TNF-alpha inhibitors demonstrate efficacy in managing HS in patients with co-existing CD.
Abstract:
Hidradenitis Suppurativa (HS) is characterized by chronic recurrent abscesses, nodules and draining sinus tracts with scar formation. Cutaneous Crohn's Disease (CD) may also present similarly. We wished to identify and describe an Irish cohort with combined HS and CD, with a view to a better recognition of clinical manifestations and understanding of the pathophysiology underlying these two overlapping conditions. Cases were identified using the HIPE Code at Tallaght Hospital from 1990-2014 and retrospective review was performed. Seven patients with both HS and CD were identified, 5(71%) female. The median age of diagnosis with both conditions was 37 years. In all cases, CD had preceded the diagnosis of HS. All patients smoked. Six had an increased BMI and 43% had additional autoimmune conditions. All patients required treatment with a TNF-alpha inhibitor for HS with 5 of 6 subjects having reduced frequency of flare ups and clinically less active HS on follow up.
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