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Is AD associated with Hidradenitis Suppurativa?


A retrospective cohort study published in the International Journal of American Academy of Dermatology investigated the possible association between atopic dermatitis and hidradenitis suppurativa.

Both hidradenitis suppurative (HS) and atopic dermatitis (AD) are chronic inflammatory skin conditions and researchers in a study published in the International Journal of American Academy of Dermatology are investigating whether they may be associated with each other.1

HS is a disease that affects about .1% to .7% of the population and features deep-seated, painful nodules and draining tunnels in 1 or more predilection skin areas, such as the axilla and groin.

The retrospective cohort study examined AD patients seen at Duke University Medical Center from 2007 to 2017 compared to a control group of non-AD patients. The association of AD and HS was evaluated using a logistic regression model after adjusting for other confounders including age, sex, and race, the article explained.

The AD group was composed of a slightly higher amount of female patients (58.4% vs 54.7%) and Black patients (37.6% vs 22.3%) vs the non-AD control group. The AD group had a younger median age of 23.6 years vs 38.4 years in the control group. In total, 28,780 patients diagnosed with AD were investigated and included in the data. There were 325 patients, 1.1%, were also diagnosed with HS. When compared to the 48,383 patients in the non-AD group, only 76 patients, .2%, were diagnosed with HS. For these 76 patients, the median age at HS diagnosis was 29 years (Q1-Q3: 20.2-41.2).

An adjusted logistic regression model demonstrated an increased odds ratio of having HS diagnosis in the AD group as compared with the control non-AD group (odds ratio: 5.57, 95% confidence interval: 4.30-7.21, P < .001).

This study was limited by it being a retrospective analysis at 1 institution and the possibility of surveillance bias being present, the researchers explained.

“Patients with AD are more likely to be diagnosed with HS than patients without AD,” the authors concluded. “Further research is needed to understand the pathophysiologic mechanism and potential treatment implications.”


Amanda Macleod, MD, consulted for Silab when she was an employee at Duke University. The MacLeod laboratory has previously received funds from Silab Company ; funding from this partnership was not directly used for this study. Silab did not have any influence on the content of this project. Dr Macleod is also consulting for the LEO Foundation. The spouse of Macleod is employed at Precision Biosciences and has stock options. 

Tarannum Jaleel, MD, MHSc, is an investigator for UCB and reported consulting for Eli Lilly and Chemocentryx and receiving honoraria.

None of the content or the decision to publish has been affected by the authors' involvement with Eli Lilly, Silab, Chemocentryx, Precision Biosciences or the LEO foundation.


1. Kaakati RN, Tanaka J, Liu B, et al. Atopic dermatitis is associated with hidradenitis suppurativa diagnosis: A single institution retrospective cohort study. JAAD International. 2021;4:18-24. doi:10.1016/j.jdin.2021.04.006

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