Higher Risk of Lymphoma With Hidradenitis Suppurativa

By Will Boggs MD

February 11, 2019

NEW YORK (Reuters Health) - People with hidradenitis suppurativa face a lymphoma risk twice that of the general population, researchers report.

Chronic inflammation like that seen in hidradenitis suppurativa (HS) can result in the development of clonal immune-cell populations, which, in turn, could give rise to malignant lymphomas.

To investigate, Dr. Amit Garg and colleagues from the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, in New Hyde Park, New York, used information from the IBM Explorys database of 55 million people from 27 integrated health systems across the U.S.

Overall, the prevalence of non-Hodgkin lymphoma (NHL) was 0.40% among individuals with and 0.35% among those without HS; the prevalences of Hodgkin lymphoma (HL) were 0.17% versus 0.09%, respectively, and the prevalences of cutaneous T-cell lymphoma (CTCL) were 0.06% versus 0.02%.

After adjustment for other variables, patients with HS had two-fold increased odds of having NHL, 2.21-fold increased odds of having HL, and 4.31-fold increased odds of having CTCL, compared with patients without HS, the researchers report in JAMA Dermatology, online January 30. All risk increases were statistically significant.

In subgroup analyses, males with HS were about twice as likely as females with HS to have NHL, HL or CTCL. The prevalences of NHL and CTCL in patients with HS aged 65 years or older were significantly higher than in younger patients.

"To our knowledge, this is the first investigation to systematically evaluate this association in a US population of patients with HS," the researchers note.

Dr. Adam Friedman from George Washington School of Medicine and Health Sciences, in Washington, D.C., who recently reviewed the newest findings regarding comorbidities associated with HS and other dermatologic diseases, told Reuters Health by email, "Hidradenitis suppurativa is a chronic disabling disease which can have significant consequences to the patient if misdiagnosed, mismanaged, and mistreated."

"I think these findings highlight the importance of treating this condition systemically as well as open the door to more in-depth conversations with our patients about what this condition is," he said. "Many HS sufferers are misdiagnosed for years (average 6-10) and have no clue that the prevalence is relatively high (as high as 4% in some studies in the US population). This research proves that a) people give a damn, b) we are attempting to learn more about the condition, and c) that they are not alone in suffering through this."

Dr. Garg did not respond to a request for comments.

SOURCE: https://bit.ly/2SgzJ4F

JAMA Dermatol 2019.