Hidradenitis Suppurativa and the Association With Hematological Malignancies.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting skin sites with a high density of apocrine glands. HS commonly presents after puberty, with most patients diagnosed in the second decade of their life. Several studies have investigated smoking, obesity, hypertension, diabetes, and dyslipidemia as possible underlying risk factors for HS. However, we encountered 2 patients with a long-standing history of untreated leukemia who developed late-onset HS.

OBJECTIVE: To investigate the presence of malignancy as an underlying risk factor for development of HS.

METHOD: The PubMed and Scopus databases were searched for keywords such as hidradenitis suppurativa, malignancy, cancer, and epidemiology.

OBSERVATION: Only 1 retrospective Swedish study with 2119 patients investigated the prevalence of cancer, including 6 hematopoietic malignancies, in HS patients. However, the study did not assess the timeline of developing HS in relation to the cancer diagnosis. We report 2 patients with a long-standing history of hematopoietic cancers who received no continuous treatments for their malignancies and developed late-onset HS: a 60-year-old male patient with hairy cell leukemia and a 68-year-old male patient with chronic lymphocytic leukemia who developed HS later in life.

CONCLUSION: Multiple epidemiologic studies found the average age of HS diagnosis to be well prior to the fourth decade of life. The latency of the HS diagnosis as well as the presence of long-standing leukemia in both of our patients raises the necessity for assessing the possibility of malignancy, especially hematopoietic cancer, as a risk factor for HS.

LIMITATION: This is a small retrospective analysis including only 2 patients. Larger studies would better assess the role of malignancy, leukemia in particular, as a possible risk factor for development of HS.