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Original Article

Characteristics of inflammatory eye disease associated with hidradenitis suppurativa

Didem Saygın 1 , Abrahim U. Syed 2 , Careen Y. Lowder 3 , Sunil Srivastava 3 , Juan J. Maya 4 , Rula A. Hajj-Ali 4
1.

Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

2.

Department of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA

3.

Department of Ophtalmology, Cleveland Clinic Lerner School of Medicine, Cleveland, Ohio, USA

4.

Department of Rheumatology, Cleveland Clinic Lerner School of Medicine, Cleveland, Ohio, USA

Eur J Rheumatol 2018; 5: 165-168
DOI: 10.5152/eurjrheum.2018.17163
Keywords : Hidradenitis suppurativa, inflammatory eye disease, uveitis, biologics
Read: 3344 Downloads: 1272 Published: 03 September 2019
Volume 5, Issue 3, September 2018
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Abstract

Objective: Hidradenitis suppurativa (HS) is an inflammatory skin condition that can cause profound morbidity. Patients can present with recurrent nodules, sinus tract formation, abscesses, and/or scarring, mainly affecting the intertriginous areas. Case reports have documented the coexistence of HS and inflammatory eye disease (IED). Herein, we aimed to assess the types of IED associated with HS and 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 and sicca were excluded, and only those with chronic IED were included. An independent ophthalmologist 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 study after the exclusion of 436 cases due to lack of data. The mean age at the diagnosis of HS and IED was 42.1 and 43.6 years, respectively. Thirteen patients had uveitis (65%), six had scleritis (30%), and one had peripheral ulcerative keratitis. Thirteen out of 20 patients (65%) had multiple autoimmune and/or inflammatory comorbidities, including inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, and lupus. Seven patients (35%) did not have any comorbid inflammatory/autoimmune conditions.


Conclusion: One-third of the patients with HS and IED did not have any autoimmune or inflammatory comorbidity that could explain the eye involvement. The potential association between HS and IED might be a manifestation of a common immune dysregulation phenomenon. Furthermore, the management of IED required an escalation of therapy to systemic immunosuppressive agents in 70% of patients with HS.


Cite this article as: Saygın D, Syed AU, Lowder CY, Srivastava S, Maya JJ, Hajj-Ali RA. Characteristics of inflammatory eye disease associated with hidradenitis suppurativa. Eur J Rheumatol 2018; 5(3): 165-8.

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