Original article
Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: A chart-verified case-control analysis

A portion of these findings were presented as a poster at the Society of Investigative Dermatology Conference in Albuquerque, NM, on May 10, 2014.
https://doi.org/10.1016/j.jaad.2014.09.012Get rights and content

Background

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving intertriginous skin. Previous epidemiologic studies have been limited by small sample size.

Objective

We sought to describe the prevalence and comorbidities of HS in a large patient care database.

Methods

In this retrospective case-control study, we chart-validated all patients within a hospital database who received at least 1 billing code for HS between 1980 and 2013. Verified cases were matched with controls based on age, gender, and race. Prevalences of a priori selected comorbidities were compared between HS and control groups.

Results

A total of 2292 patients at Massachusetts General Hospital received at least 1 code for HS. A total of 1776 cases had a validated diagnosis of HS, yielding a prevalence of 0.08%. In unadjusted analysis, all comorbidities were diagnosed significantly more in HS compared with control including (in rank order of likelihood): smoking, arthropathies, dyslipidemia, polycystic ovarian syndrome, psychiatric disorders, obesity, drug dependence, hypertension, diabetes, thyroid disease, alcohol dependence, and lymphoma (all P < .01).

Limitations

Control subjects were not validated for absence of HS and comorbidity validation was not performed for either group.

Conclusions

Our results highlights the high comorbidity burden of patients with HS compared with matched control subjects.

Section snippets

Methods

This was a retrospective, matched case-control study. After protocol approval by the Partners Healthcare Human Research Committee, the Research Patient Data Registry (RPDR) at Massachusetts General Hospital was queried to identify all patients who received at least 1 ICD-9 code for HS (705.83) between January 1, 1980, and October 1, 2013. The medical records of all returned cases were manually reviewed using the Massachusetts General Hospital electronic medical record and Queriable Patient

Results

Our initial RPDR query of all patients who received at least 1 ICD-9 code of 705.83 between January 1, 1980, and October 1, 2013, yielded 2292 potential cases. A complete chart review resulted in 1776 verified cases of HS and a positive predictive value of 77% (1776/2292) for the code of 705.83 in predicting HS in this population. When compared with the entire population of Massachusetts General Hospital patients within RPDR, the prevalence of HS was 0.078% (1776/2,279,254). The mean age (SD)

Discussion

In this study, we used chart-verified patients who received at least 1 ICD-9 code for HS within a large, electronic medical record database, yielding an overall prevalence of 0.078% of HS within this population. Our prevalence is consistent with other reports of claims-based data in the United States but lower than results from European studies, which relied on patient self-report and estimated prevalence rates between 1% and 4%.3, 4, 5, 6 With a prevalence of only 78 per 100,000 our data

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    Dr Shlyankevich has partial fellowship funding from Janssen.

    Disclosure: Dr Kimball has served as an investigator and consultant for Abbvie. Dr Shlyankevich has partial fellowship funding from Janssen. Ms Chen and Ms Kim have no conflicts of interest to declare.

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