Polycystic ovary syndrome diagnosis does not predict increased hidradenitis suppurativa severity

Abstract Hidradenitis suppurativa (HS) is a painful inflammatory disorder of follicular biology. Androgens are believed to play a role in HS pathogenesis; however, the mechanism remains unclear. The high frequency of polycystic ovary disease (PCOS) in HS suggests the influence of testosterone as a driver of disease. In order to assess the impact of PCOS on HS severity, we conducted a retrospective chart review of 55 female patients with HS-PCOS and 57 female HS-controls. Demographic information and disease severity (as measured by HS-physician global assessment, numerical rating scale-pain score, erythrocyte sedimentation rate, c-reactive protein, interleukin-6, testosterone levels, hemoglobin A1C, and treatment protocols) were recorded. Testosterone levels in the HS-PCOS cohort were statistically higher than controls ( p < 0.05). Binomial logistic regressions showed no statistical differences in age, sex, race, HS severity, and inflammatory markers when comparing the HS-PCOS cohort with HS-controls. Additionally, there were no significant differences in the range and frequency of HS therapies in these groups. Study limitations include small sample size and cross-sectional design. We report that patients with HS-PCOS have neither increased HS disease severity nor require more aggressive treatments than HS-controls.