Association Between Hidradenitis Suppurativa and Polycystic Ovary Syndrome

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with metabolic and hormonal comorbidities. This study analyzed the association between HS and polycystic ovary syndrome (PCOS) using data from the National Institute of Health's All of Us Research Program database. In a cross-sectional analysis of 78,742 females, 5.64% of those with HS had PCOS compared with 0.93% of those without HS. After adjusting for age, race/ethnicity, smoking status, type 2 diabetes, and obesity, females with HS were found to be 2.06 times more likely to have PCOS (95% CI, 1.41-3.02; P<.001). In unadjusted analyses stratified by race/ethnicity, HS was associated with increased odds of PCOS within each group. Non-Hispanic Black and Hispanic patients were less likely to have PCOS compared with White patients, possibly reflecting disparities in diagnosis. Obesity and type 2 diabetes also were strongly associated with PCOS, conferring 11.14- and 10.43-fold increased odds, respectively. These findings underscore the importance of PCOS screening among patients with HS, particularly for minority populations. Shared hormonal and metabolic pathways may contribute to the observed associations, supporting the use of antiandrogen therapies and oral contraceptives for treatment. Further research is warranted to explore the shared pathophysiology and improve targeted care for patients with both conditions.