Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States

Background: Hidradenitis suppurativa (HS) and alopecia areata (AA) share similar inflammatory pathway and pro-inflammatory cytokines. However, the association between HS and AA was unclear. We aimed to evaluate the risk of incident AA among patients with HS. Material and methods: We performed a mult...

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Main Authors: Shuo-Yan Gau, Chih-Wei Chen, Yu-Hsun Wang, Ching-Chi Chi, James Cheng-Chung Wei
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Biomedical Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2319417025000113
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author Shuo-Yan Gau
Chih-Wei Chen
Yu-Hsun Wang
Ching-Chi Chi
James Cheng-Chung Wei
author_facet Shuo-Yan Gau
Chih-Wei Chen
Yu-Hsun Wang
Ching-Chi Chi
James Cheng-Chung Wei
author_sort Shuo-Yan Gau
collection DOAJ
description Background: Hidradenitis suppurativa (HS) and alopecia areata (AA) share similar inflammatory pathway and pro-inflammatory cytokines. However, the association between HS and AA was unclear. We aimed to evaluate the risk of incident AA among patients with HS. Material and methods: We performed a multicenter cohort study using the US Collaborative Network in the TriNetX Research Network. Patients with HS diagnosis were recruited and 1:1 propensity score matching was performed to identify the non-HS control group. Hazard ratio (HR) of AA in different sensitivity models were calculated within the follow-up periods. Results: Comparing with non-HS controls, the risk of incident AA in HS patients was 1.79-fold higher (95% confidence interval (CI) 1.31−2.44) within 15-year follow up. Similar trends were observed in 3-year and 8-year follow up. For female HS patients, the risk of incident AA was 1.75-fold higher than non-HS female (95% CI 1.23−2.48). However, the trend was not observed in male HS patients (HR 1.52; 95% CI 0.79−2.94). Conclusions: Patients with HS were associated with increased risk of incident AA. Clinicians should be aware of the observed association and the actual immunological interplay between the two diseases should be clarified in future lab-based studies.
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spelling doaj-art-0378d23ca93c4aef972fa0c7c0a425842025-08-20T02:44:50ZengElsevierBiomedical Journal2319-41702025-06-0148310083710.1016/j.bj.2025.100837Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United StatesShuo-Yan Gau0Chih-Wei Chen1Yu-Hsun Wang2Ching-Chi Chi3James Cheng-Chung Wei4School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Education, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung, Taiwan; Department and Graduate Institute of Business Administration, College of Management, National Taiwan University, Taipei, TaiwanData Finance Innovation Research Center, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; National Council for Sustainable Development, Executive Yuan, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Faculty of Engineering Sciences, University College London, London, UKDepartment of Medical Research, Chung Shan Medical University Hospital, Taichung, TaiwanDepartment of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Department of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University, Taichung, Taiwan; Corresponding author. Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, No. 2, Yude Road, North District, Taichung City 40447, Taiwan.Background: Hidradenitis suppurativa (HS) and alopecia areata (AA) share similar inflammatory pathway and pro-inflammatory cytokines. However, the association between HS and AA was unclear. We aimed to evaluate the risk of incident AA among patients with HS. Material and methods: We performed a multicenter cohort study using the US Collaborative Network in the TriNetX Research Network. Patients with HS diagnosis were recruited and 1:1 propensity score matching was performed to identify the non-HS control group. Hazard ratio (HR) of AA in different sensitivity models were calculated within the follow-up periods. Results: Comparing with non-HS controls, the risk of incident AA in HS patients was 1.79-fold higher (95% confidence interval (CI) 1.31−2.44) within 15-year follow up. Similar trends were observed in 3-year and 8-year follow up. For female HS patients, the risk of incident AA was 1.75-fold higher than non-HS female (95% CI 1.23−2.48). However, the trend was not observed in male HS patients (HR 1.52; 95% CI 0.79−2.94). Conclusions: Patients with HS were associated with increased risk of incident AA. Clinicians should be aware of the observed association and the actual immunological interplay between the two diseases should be clarified in future lab-based studies.http://www.sciencedirect.com/science/article/pii/S2319417025000113Hidradenitis suppurativaAlopecia areataCohort studiesTriNetXImmune-mediated inflammatory dermatosisRisk
spellingShingle Shuo-Yan Gau
Chih-Wei Chen
Yu-Hsun Wang
Ching-Chi Chi
James Cheng-Chung Wei
Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States
Biomedical Journal
Hidradenitis suppurativa
Alopecia areata
Cohort studies
TriNetX
Immune-mediated inflammatory dermatosis
Risk
title Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States
title_full Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States
title_fullStr Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States
title_full_unstemmed Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States
title_short Increased risk of incident alopecia areata among patients with hidradenitis suppurativa: A multicenter cohort study in the United States
title_sort increased risk of incident alopecia areata among patients with hidradenitis suppurativa a multicenter cohort study in the united states
topic Hidradenitis suppurativa
Alopecia areata
Cohort studies
TriNetX
Immune-mediated inflammatory dermatosis
Risk
url http://www.sciencedirect.com/science/article/pii/S2319417025000113
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