Hidradenitis suppurativa and association with stroke: systematic review and meta-analysis

Abstract

Purpose

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful nodules, abscesses, sinus tract formation and scarring. The relationship between HS and strokes is not well established. To assess this potential association, a systematic review and meta-analysis was performed according to PRISMA guidelines.

Materials and methods

Electronic searches were performed from six online databases. All eligible case-control studies comparing patients with HS versus non-HS were included. All studies must have included either the proportion of patients with strokes (identified via ICD-9 or ICD-10 codes) in each group, or the summary effect size for association between HS and strokes. Odds ratio (OR) with 95% confidence interval (CI) was used as the effect size.

Results

Through our search, we identified six case-control studies for inclusion. From pooled data, we found a significantly higher proportion of strokes in HS cases compared with controls (OR 1.74, 95% CI 1.45–2.09; p < .00001). Limitations included those studies reviewed were observational by design which are susceptible to bias and lack of randomization.

Conclusion

Our pooled findings demonstrate that the odds of stroke are increased in patients with HS when compared with controls. Dermatologists and other clinicians should be vigilant cerebrovascular risk assessment and risk mitigation in patients with HS.

Keywords:

• Hidradenitis suppurativa
• acne inversa
• cerebrovascular disease
• cerebrovascular accident
• stroke
• ischemic stroke
• comorbidities

Disclosure statement

Dr. A Garg has served as an advisor for AbbVie, Amgen, Boehringer Ingelheim, Janssen, Pfizer, Incyte, InfalRx, Viela Bio, UCB, and has received honoraria. Dr. SD Smith is an investigator for clinical trials with UCB and Abbvie and has received sponsorship from Abbvie for international conference attendance, and honoraria from Abbvie for educational presentations and advisory board membership.