Risk of New-Onset Hidradenitis Suppurativa in People with Polycystic Ovary Syndrome: a large-scale propensity-score-matched cohort study

<b>Background:</b> Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, while polycystic ovary syndrome (PCOS) is an endocrine disorder. Both conditions share common risk factors, such as androgen excess and obesity. This study aimed to investigate the association between PCOS and the risk of developing HS. <b>Method:</b> A retrospective cohort study was conducted using data from the TriNetX research network, focusing on female patients aged over 18 with PCOS. A control group without PCOS was matched based on age, race, and body mass index using propensity score matching. Hazard ratios (HRs) were calculated to evaluate the risk of HS in PCOS patients across various models. <b>Results:</b> After matching, 141,661 PCOS patients and an equal number of controls were analyzed. PCOS patients showed a significantly increased risk of developing HS (HR: 2.061, 95% confidence interval (CI): 1.910-2.225). The risk remained elevated across different models and sensitivity analyses. Stratified analyses revealed the highest HS risk in younger women (aged 18-39; HR: 2.103, 95% CI: 1.911,2.315), those with a BMI less than 30 (HR: 2.053, 95% CI: 1.761,2.393) and those without diabetes (HR: 1.814, 95% CI: 1.657,1.986). <b>Conclusion:</b> PCOS patients are at a significantly higher risk of developing HS, particularly among younger and more severely affected individuals. Clinical awareness and early detection are essential for managing inflammatory comorbidities in PCOS patients.