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

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.