Ocular Screening Needed In Hidradenitis Suppurativa Cases

A study shows that patients with hidradenitis suppurativa are at significant risk for episcleritis.

Patients with hidradenitis suppurativa should undergo a brief assessment of both ocular history and current symptoms during routine dermatology visits to identify those ocular comorbidities, according to a research letter published in JAMA Dermatology. Those who do exhibit comorbidities should be referred to an ophthalmologist, the letter says.  

Currently, there is a lack of data in the literature about ocular comorbidities in hidradenitis suppurativa. To rectify this, a team of researchers sought to quantify the burden of these ocular comorbidities in this patient population. 

Using data from IBM’s Explorys — a large, real-world, cloud-based, aggregate database — researchers conducted a case-control study comparing ocular comorbidities in people with hidradenitis suppurativa with a control group. Terms including anterior, posterior, and chronic uveitis, scleritis, episcleritis, interstitial keratitis, and conjunctivitis were used to identify ocular comorbidities. Patients with other autoimmune diseases, such as psoriasis, rheumatoid arthritis, Crohn disease, diabetes, and HIV, among others, were excluded. 

Researchers identified 31,400 patients with hidradenitis suppurativa (74.4% women), 13.89% of whom had ocular comorbidities, compared with 3.2% of patients in the control group (P <.001). 

Anterior, posterior, and chronic uveitis were present in 0.6%, 0.1%, and 0.1% of people with hidradenitis suppurativa, compared with 0.1%, 0.01%, and 0.01% of patients in the control group (odds ratios [OR], 1.41, 1.07, and 1.25, respectively). Those with hidradenitis suppurativa had a “significantly increased” OR for episcleritis (2.06; 95% CI, 1.78-2.34; P <.001). ORs for keratitis and conjunctivitis were also increased in this group (1.54 and 1.27; P <.001 for both), but not for interstitial keratitis (OR, 1.31; 95% CI, 0.9-1.73; P =.21). 

Study limitations include the limited ability to account for potential confounders due to the aggregate nature of the data and misclassification bias. 

“Among this cohort, patients with [hidradenitis suppurativa] had an increased burden of ocular comorbidities. These data suggest that, while uncommon, a brief assessment of ocular history and symptoms during routine visits could help identify patients with [hidradenitis suppurativa] who should see an ophthalmologist,” the researchers concluded.


Conic RRZ, Fabborocini G, Marasca C, et al. Burden of ocular comorbidities in patients with hidradenitis suppurativa. JAMA Dermatol. Published online January 6, 2020. doi:10.1001/jamadermatol.2020.5087