Hidradenitis suppurativa: evidence for an endocrine abnormality

Women patients with premenstrual exacerbation of hidradenitis suppurativa have been studied to determine if an endocrine abnormality can be detected. A functional disorder of the hypothalamopituitary axis was found in 13 patients with hidradenitis when compared with 9 controls. In response to a combined thyrotrophin releasing hormone and gonadotrophin releasing hormone test, the prolactin and TSH responses were significantly greater in the hidradenitis patients than the controls. No significant differences were found in the mean basal levels of oestrogen, progesterone, testosterone, dehydroepiandrosterone sulphate, T3 and T4. These results may reflect a disturbance of feedback signals from peripheral hormones, rather than a primary dysfunction of the control of specific anterior pituitary cells.