Hidradenitis Suppurativa Linked to Inflammatory Eye Disease

Nearly a quarter of patients with hidradenitis suppurativa (HS) experienced concomitant eye disease, and among those who did, nearly one third had a partial response with treatment, results from a systematic review showed.

“Inflammatory and autoimmune comorbidities have been documented in HS, but the association between HS and inflammatory eye diseases is rare,” lead study author Hibo Rijal, a fourth-year student at Queen’s University School of Medicine, Kingston, Ontario, Canada, told Medscape Medical News in advance of the annual Symposium on Hidradenitis Suppurativa Advances, where the study results were presented during an oral abstract session.

To investigate the prevalence of inflammatory eye disease and response to therapy in patients with HS, the researchers searched the Cochrane, Embase, and MEDLINE databases for relevant studies. The final analysis included 21 studies involving 355 individuals with a mean age of 39 years. Most (71%) were women, and 79 cases (22.3%) of inflammatory eye disease were reported in the study population. The three most common types of inflammatory eye disease were keratitis (26 cases, or 33%), uveitis (25 cases, or 32%), and scleritis (8 cases, or 10%).

“Prior to this [review], uveitis was the most commonly known subtype of this disease comorbidity,” Rijal said. “As keratitis has been more commonly associated with infections and external factors as opposed to autoimmune diseases, it would be intriguing to know potential exacerbating symptoms of ocular symptoms in patients in this review to further understand the pathophysiology.”

Among the 79 cases of inflammatory eye disease, the average latency period following the diagnosis of HS was 9.7 months, and the average documented Hurley score was 2.9. Among the 51 cases that warranted treatment, data on response to therapy were available for 31 cases (60.8%). Among these 31 cases, 22 (71%) achieved a complete response (12 with steroid therapy and 10 with systemic biologic therapy) and nine (29%) achieved a partial response (five with corticosteroids, three with systemic biologics, and one with antibiotics).

Rijal acknowledged certain limitations of the review, including the paucity of studies on the topic. “There were very few studies found documenting comorbid inflammatory eye disease and HS,” and there were fewer that discussed outcomes of treatment for the ocular symptoms, she noted. “That being said, this review can thus act as a call to action for researchers to conduct larger trials investigating this association and potential response to dually effective immunotherapies.”

Rijal and her coauthors reported having no relevant financial disclosures.