medwireNews: More research is needed to investigate the role of sex hormones in driving hidradenitis suppurativa (HS), US investigators urge after uncovering an association between precocious puberty (PP) and the skin condition.
Amit Garg, from the Zucker School of Medicine at Hofstra/Northwell in New York, uncovered more than twice the incidence of PP in patients diagnosed with HS compared with healthy individuals.
HS has previously been associated with sex hormone disorders, including the androgen-mediated disorders of polycystic ovary syndrome and acne, the researchers explain.
To investigate whether it is also linked with PP – defined as accelerated androgen production leading to the premature development of secondary sexual characteristics – Garg et al reviewed data for 1605 patients with HS aged 8–18 years and 180,933 controls who were included in the Explorys database of more than 40 US healthcare networks between March 2017 and February 2020.
The patients were aged a median of 17 years and 81.9% were girls, while the controls were aged a median of 13 years and 49.5% were girls. Most of the patients with and without HS were White (56.4 vs 74.2%). There was a difference between the groups regarding BMI, with 58.9% of patients with HS having obesity compared with 23.4% of controls, the latter being more likely to have a healthy weight (56.3 vs 22.8%).
Overall, 2.5% of patients with HS and 1.2% of controls were diagnosed with PP.
HS was associated with PP in an unadjusted model (odds ratio [OR]=2.16) and was significantly associated with HS after adjusting for sex, race, age, and BMI category, with an OR of 2.13. Complete case sensitivity analysis, discarding participants with missing data, also gave a significant OR of 2.33 for the association.
Garg et al say that their findings are “consistent with a small cross-sectional study from Europe and offer additional evidence to support the role of sex hormones in the pathophysiology of HS.”
They conclude: “Although hormonal mechanisms driving HS are incompletely understood, elevated expression of androgen receptors in the epidermis, infundibula and tunnels of HS lesions compared with normal skin indicates that keratinocytes and apocrine glands may function as target cells for androgen-mediated reactions in HS.”
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