Characteristics of inflammatory eye disease associated with hidradenitis suppurativa

Abstract

Objective: Hidradenitis suppurativa (HS) is an inflammatory skin condition that can cause profoundmorbidity. Patients can present with recurrent nodules, sinus tract formation, abscesses, and/or scar-ring, mainly affecting the intertriginous areas. Case reports have documented the coexistence of HSand inflammatory eye disease (IED). Herein, we aimed to assess the types of IED associated with HSand the outcomes of IED treatment in patients with HS.Methods: All the cases with a diagnosis of HS and any IED were identified. Patients with episcleritis andsicca were excluded, and only those with chronic IED were included. An independent ophthalmolo-gist reviewed notes to ensure accuracy of IED diagnosis. Demographics, IED patterns, comorbidities,treatments, and outcomes were retrieved from patient charts.Results: Twenty patients [16 females (80%); 12 African Americans (60%)] were included in this studyafter the exclusion of 436 cases due to lack of data. The mean age at the diagnosis of HS and IED was42.1 and 43.6 years, respectively. Thirteen patients had uveitis (65%), six had scleritis (30%), and onehad peripheral ulcerative keratitis. Thirteen out of 20 patients (65%) had multiple autoimmune and/orinflammatory comorbidities, including inflammatory bowel disease, rheumatoid arthritis, ankylosingspondylitis, multiple sclerosis, and lupus. Seven patients (35%) did not have any comorbid inflamma-tory/autoimmune conditions.Conclusion: One-third of the patients with HS and IED did not have any autoimmune or inflammatorycomorbidity that could explain the eye involvement. The potential association between HS and IEDmight be a manifestation of a common immune dysregulation phenomenon. Furthermore, the man-agement of IED required an escalation of therapy to systemic immunosuppressive agents in 70% ofpatients with HS.