Hematologic Malignancy Prevalence in Hidradenitis Suppurativa: A Cross-Sectional Study

Parsa Abdi; Zaim Haq; Michael J. Diaz; Maheen Raja; Eric McMullen; Jessica Asgarpour; Sepideh Emam; Robert Gniadecki; David Croitoru

doi:10.53941/dss.2026.100010

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with substantial comorbidity. Evidence regarding the co-occurrence of HS and recorded hematologic malignancy diagnoses in large, diverse electronic health record populations remains limited. Methods: We conducted a cross-sectional analysis using standardized electronic health record data from the All of Us Research Program. Adults aged 18–90 years with available electronic health records were included. Participants with HS were identified using ICD-10-CM and SNOMED diagnostic codes matched to controls without recorded HS in a 1:4 ratio using nearest-neighbor propensity-score. Matching was based on age, gender, and race/ethnicity. Matching was performed without replacement using a caliper of 0.2 standard deviations of the logit of the propensity score. Multivariable logistic regression models with cluster-robust standard errors for matched sets were used to evaluate associations between HS and recorded hematologic malignancy diagnoses. Results: The matched cohort included 2636 participants with HS and 10,544 controls. The primary complete-case analysis included 1544 participants with HS and 6176 controls. Any recorded hematologic malignancy was identified in 72 participants with HS (4.66%) and 151 controls (2.44%) and was associated with HS after covariate adjustment (adjusted odds ratio [aOR], 2.04; 95% CI, 1.62–2.47). Recorded diagnoses of multiple myeloma (22 [1.42%] vs. 25 [0.40%]; aOR, 3.64; 95% CI, 2.29–6.24), leukemia (24 [1.55%] vs. 41 [0.66%]; aOR, 2.30; 95% CI, 1.46–3.82), and malignant lymphoma (39 [2.53%] vs. 95 [1.54%]; aOR, 1.83; 95% CI, 1.30–2.57) were also more frequently recorded among participants with HS. Conclusions: HS was associated with increased adjusted odds of recorded hematologic malignancies in this large, diverse cohort. Longitudinal studies are needed to establish temporality and causality.

References

1.
Vinkel, C.; Thomsen, S.F. Hidradenitis Suppurativa: Causes, Features, and Current Treatments. J. Clin. Aesthet. Dermatol. 2018, 11, 17–23.
2.
Jemec, G.B.E.; Kimball, A.B. Hidradenitis suppurativa: Epidemiology and scope of the problem. J. Am. Acad. Dermatol. 2015, 73, S4–S7. https://doi.org/10.1016/j.jaad.2015.07.052.
3.
Lim, Z.V.; Oon, H.H. Management of Hidradenitis Suppurativa in Patients. Available online: https://scholar.google.com/scholar_lookup?title=Management%20of%20hidradenitis%20suppurativa%20in%20patients%20with%20metabolic%20comorbidities&publication_year=2016&author=Z.V.%20Lim&author=H.H.%20Oon (accessed on 11 March 2026).
4.
Zouboulis, C.C.; Benhadou, F.; Byrd, A.S.; et al. What causes hidradenitis suppurativa?—15 years after. Exp. Dermatol. 2020, 29, 1154–1170. https://doi.org/10.1111/exd.14214.
5.
Cartron, A.; Driscoll, M. Comorbidities of hidradenitis suppurativa: A review of the literature. Int. J. Womens Dermatol. 2019, 5, 330–334. https://doi.org/10.1016/j.ijwd.2019.06.026.
6.
Dauden, E.; Lazaro, P.; Aguilar, M.D.; et al. Recommendations for the management of comorbidity in hidradenitis suppurativa. J. Eur. Acad. Dermatol. Venereol. 2018, 32, 129–144. https://doi.org/10.1111/jdv.14517.
7.
Geng, Z.; Ye, C.; Zhu, X. Malignancies in systemic rheumatic diseases: A mini review. Front. Immunol. 2023, 14, 1095526. https://doi.org/10.3389/fimmu.2023.1095526.
8.
Hemminki, K.; Huang, W.; Sundquist, J.; et al. Autoimmune diseases and hematological malignancies: Exploring the underlying mechanisms from epidemiological evidence. Semin. Cancer Biol. 2020, 64, 114–121. https://doi.org/10.1016/j.semcancer.2019.06.005.
9.
Anderson, L.A.; Gadalla, S.; Morton, L.M.; et al. Population‐based study of autoimmune conditions and the risk of specific lymphoid malignancies. Int. J. Cancer 2009, 125, 398–405. https://doi.org/10.1002/ijc.24287.
10.
Noureldine, H.A.; Nour-Eldine, W.; Hodroj, M.H.; et al. Hematological malignancies in connective tissue diseases. Lupus 2020, 29, 225–235. https://doi.org/10.1177/0961203319899986.
11.
Andersen, R.; Rostgaard, K.; Pedersen, O.; et al. Increased cancer incidence among patients with hidradenitis suppurativa–A Danish nationwide register study 1977–2017. Acta Oncol. 2024, 63, 220–228. https://doi.org/10.2340/1651-226x.2024.26182.
12.
Abu Rached, N.; Rüth, J.; Gambichler, T.; et al. A state-of-the-art systematic review of cancer in hidradenitis suppurativa. Ann. Med. 2024, 56, 2382372. https://doi.org/10.1080/07853890.2024.2382372.
13.
Tannenbaum, R.; Strunk, A.; Garg, A. Association Between Hidradenitis Suppurativa and Lymphoma. JAMA Dermatol. 2019, 155, 624–625. https://doi.org/10.1001/jamadermatol.2018.5230.
14.
Jung, J.M.; Lee, K.H.; Kim, Y.J.; et al. Assessment of Overall and Specific Cancer Risks in Patients with Hidradenitis Suppurativa. JAMA Dermatol. 2020, 156, 844–853. https://doi.org/10.1001/jamadermatol.2020.1422.
15.
von Elm, E.; Altman, D.G.; Egger, M.; et al. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007, 335, 806–808. https://doi.org/10.1136/bmj.39335.541782.ad.
16.
All of Us Research Program Investigators; Denny, J.; Rutter, J.; et al. The “All of Us” Research Program. N. Engl. J. Med. 2019, 381, 668–676. https://doi.org/10.1056/nejmsr1809937.
17.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013, 310, 2191–2194. https://doi.org/10.1001/jama.2013.281053.
18.
Austin, P. A comparison of 12 algorithms for matching on the propensity score. Stat. Med. 2014, 33, 1057–1069. https://doi.org/10.1002/sim.6004.
19.
Rassen, J.A.; Shelat, A.A.; Myers, J.; et al. One‐to‐many propensity score matching in cohort studies. Pharmacoepidemiol. Drug Saf. 2012, 21, 69–80. https://doi.org/10.1002/pds.3263.
20.
Ramirez, A.H.; Sulieman, L.; Schlueter, D.J.; et al. The All of Us Research Program: Data quality, utility, and diversity. Patterns 2022, 3, 100570. https://doi.org/10.1016/j.patter.2022.100570.
21.
Martora, F.; Tommasino, N.; Battista, T.; et al. Hidradenitis Suppurativa Cancer Risk: A Review of the Literature. Clin. Cosmet. Investig. Dermatol. 2025, 18, 617–626. https://doi.org/10.2147/ccid.s512373.
22.
Gudjonsson, J.E.; Tsoi, L.C.; Ma, F.; et al. Contribution of plasma cells and B cells to hidradenitis suppurativa pathogenesis. JCI Insight 2020, 5, e139930. https://doi.org/10.1172/jci.insight.139930.
23.
Lee, J.; Ham, S.; Lee, J.; et al. Spatial transcriptomics maps early B-cell and T-cell activation in hidradenitis suppurativa. J. Invest. Dermatol. 2026, 146, 2147–2158.e8. https://doi.org/10.1016/j.jid.2026.01.041.
24.
Sabat, R.; Šimaitė, D.; Gudjonsson, J.E.; et al. Neutrophilic granulocyte-derived B-cell activating factor supports B cells in skin lesions in hidradenitis suppurativa. J. Allergy Clin. Immunol. 2023, 151, 1015–1026. https://doi.org/10.1016/j.jaci.2022.10.034.
25.
Lowe, M.; Naik, H.; Clancy, S.; et al. Immunopathogenesis of hidradenitis suppurativa and response to anti–TNF-α therapy. JCI Insight 2020, 5, e139932. https://doi.org/10.1172/jci.insight.139932.
26.
Moran, B.; Smith, C.M.; Zaborowski, A.; et al. Targeting the NLRP3 inflammasome reduces inflammation in hidradenitis suppurativa skin. Br. J. Dermatol. 2023, 189, 447–458. https://doi.org/10.1093/bjd/ljad184.
27.
Shavit, E.; Dreiher, J.; Freud, T.; et al. Psychiatric comorbidities in 3207 patients with hidradenitis suppurativa. J. Eur. Acad. Dermatol. Venereol. 2015, 29, 371–376. https://doi.org/10.1111/jdv.12567.
28.
Ballard, K.; Sathe, N.; Shuman, V. Hidradenitis Suppurativa. In StatPearls; StatPearls Publishing: St. Petersburg, FL, USA, 2026. Available online: http://www.ncbi.nlm.nih.gov/books/NBK534867/ (accessed on 11 March 2026).

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