New insights in hidradenitis suppurativa from a population-based Dutch cohort: prevalence, smoking behaviour, socioeconomic status and comorbidities. — ME/CFS Atlas
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New insights in hidradenitis suppurativa from a population-based Dutch cohort: prevalence, smoking behaviour, socioeconomic status and comorbidities.
Prens, Lisette M, Bouwman, Klasiena, Troelstra, Lisa D et al. · The British journal of dermatology · 2022 · DOI
Quick Summary
This study looked at how common hidradenitis suppurativa (HS), a chronic inflammatory skin condition, is in the Netherlands, and what health problems tend to occur alongside it. Researchers surveyed over 56,000 people and found that people with HS were more likely to also have fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, and migraines. The study suggests these conditions may share common underlying causes.
Why It Matters
This study provides important evidence that ME/CFS co-occurs significantly with hidradenitis suppurativa and other inflammatory conditions, suggesting these diseases may share common pathogenic mechanisms. Understanding these associations can help researchers identify shared biological pathways and may improve clinical recognition and management of comorbidities in ME/CFS patients.
Observed Findings
HS prevalence was 2.1% among survey respondents, higher than the previously estimated 1% overall prevalence.
Patients with HS had significantly lower socioeconomic status than controls (P<0.001).
Chronic fatigue syndrome was 1.72 times more common in people with HS (95% CI 1.06-2.78).
Fibromyalgia showed the strongest association with HS (OR 2.26), and remained significant after adjusting for multiple factors.
Smoke exposure was significantly more frequent in HS patients (P<0.001).
Inferred Conclusions
Hidradenitis suppurativa has a higher prevalence in the Northern Netherlands than previously estimated globally.
ME/CFS and fibromyalgia are independently and significantly associated with HS after controlling for confounders.
Socioeconomic factors and smoking behavior are important correlates of HS that warrant further investigation.
The clustering of autoinflammatory and pain/fatigue conditions suggests potential shared biological mechanisms.
Remaining Questions
Does HS pathology directly contribute to ME/CFS symptoms, or do these conditions share a common immunological etiology?
What This Study Does Not Prove
This study does not establish causation—it only shows that HS and ME/CFS occur together more frequently than expected by chance. The self-reported nature of diagnoses means we cannot confirm that participants truly had HS or CFS as clinically diagnosed conditions. Cross-sectional design prevents determining whether one condition causes the other or if they share a common underlying cause.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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