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Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations - 28/03/21

Doi : 10.1016/j.jaad.2021.01.059 
Amit Garg, MD a, , Neeta Malviya, MD a, Andrew Strunk, MA a, Shari Wright, BS a, Afsaneh Alavi, MD b, Raed Alhusayen, MBBS, MSCE, FRCPC b, c, Ali Alikhan, MD d, Steven D. Daveluy, MD e, Isabelle Delorme, MD, FRCPC f, Noah Goldfarb, MD g, Wayne Gulliver, MD h, Iltefat Hamzavi, MD i, Tarannum Jaleel, MD j, Alexa B. Kimball, MD, MPH k, Joslyn S. Kirby, MD, MEd, MS l, Mark G. Kirchhof, MD, PhD, FRCPC m, Janice Lester, MLIS n, Hadar Lev-Tov, MD o, Michelle A. Lowes, MD, PhD p, Robert Micheletti, MD q, Lauren A. Orenstein, MD r, Vincent Piguet, MD, PhD, FRCP b, s, Christopher Sayed, MD t, Jerry Tan, MD, FRCP u, Haley B. Naik, MD, MHSc v
a Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York 
b Division of Dermatology, Faculty of Medicine, Women College Hospital, University of Toronto, Toronto, Canada 
c Department of Medicine and Sunnybrook Research Institute, University of Toronto, Toronto, Canada 
d Department of Dermatology, Sutter Medical Foundation, Sacramento, California 
e Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan 
f Dr Isabelle Delorme Inc, Dermatologue, Drummondville, Canada 
g Departments of Internal Medicine and Dermatology, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota 
h Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada 
i Multicultural Dermatology Center, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan 
j Department of Dermatology, Duke University School of Medicine, Durham, North Carolina 
k Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center, Boston, Massachusetts 
l Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania 
m Division of Dermatology, Faculty of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada 
n Clinical Medical Library, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York 
o Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida 
p The Rockefeller University, New York, New York 
q Departments of Dermatology and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 
r Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia 
s Women's College Hospital, Toronto, Canada 
t Department of Dermatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 
u Department of Internal Medicine, University of Western Ontario, Windsor Campus, Canada 
v Department of Dermatology, University of California, San Francisco, California 

Correspondence to: Amit Garg, MD, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 1991 Marcus Ave, Suite 300, New Hyde Park, NY 11042.Donald and Barbara Zucker School of Medicine at Hofstra/Northwell1991 Marcus Ave, Suite 300New Hyde ParkNY11042
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 28 March 2021
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Abstract

Background

Hidradenitis suppurativa (HS) is associated with comorbidities that contribute to poor health, impaired life quality, and mortality risk.

Objective

To provide evidence-based screening recommendations for comorbidities linked to HS.

Methods

Systematic reviews were performed to summarize evidence on the prevalence and incidence of 30 comorbidities in patients with HS relative to the general population. The screening recommendation for each comorbidity was informed by the consistency and quality of existing studies, disease prevalence, and magnitude of association, as well as benefits, harms, and feasibility of screening. The level of evidence and strength of corresponding screening recommendation were graded by using the Strength of Recommendation Taxonomy (SORT) criteria.

Results

Screening is recommended for the following comorbidities: acne, dissecting cellulitis of the scalp, pilonidal disease, pyoderma gangrenosum, depression, generalized anxiety disorder, suicide, smoking, substance use disorder, polycystic ovary syndrome, obesity, dyslipidemia, diabetes mellitus, metabolic syndrome, hypertension, cardiovascular disease, inflammatory bowel disease, spondyloarthritis, and sexual dysfunction. It is also recommended to screen patients with Down syndrome for HS. The decision to screen for specific comorbidities may vary with patient risk factors. The role of the dermatologist in screening varies according to comorbidity.

Limitations

Screening recommendations represent one component of a comprehensive care strategy.

Conclusions

Dermatologists should support screening efforts to identify comorbid conditions in HS.

Le texte complet de cet article est disponible en PDF.

Key words : acne, cardiovascular disease, comorbidity, Crohn's disease, depression, dermatologist, diabetes mellitus, dissecting cellulitis of the scalp, down syndrome, dyslipidemia, generalized anxiety disorder, guidelines, herpes zoster, hidradenitis suppurativa, hypertension, inflammatory bowel disease, lymphoma, metabolic syndrome, North America, obesity, pilonidal disease, polycystic ovary syndrome, pyoderma gangrenosum, screening, sexual dysfunction, smoking, spondyloarthritis, substance use, suicide, systemic, ulcerative colitis

Abbreviations used : aOR, CD, CI, DCS, DM, DS, HS, HZ, IL, MACE, MetS, PCOS, PD, PG, SD, SUD, TNF, UC


Plan


 Drs Garg and Malviya are cofirst authors.
 Funding sources: Dr Orenstein is supported in part by Building Interdisciplinary Research Careers in Women's Health of the National Institutes of Health (K12D085850). Dr Naik is supported in part by the National Institutes of Health (NIAMS K32 AR074531).
 IRB approval status: Reviewed and approved by the human subjects committee at the Feinstein Institute for Medical Research at the Northwell Health.
 Reprints not available from the authors.


© 2021  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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