Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul;52(2):303-310.
doi: 10.1111/apt.15863. Epub 2020 Jun 11.

Increased risk of permanent stoma in Crohn's disease associated with hidradenitis suppurativa: a case-control study

Louis-Marie Dumont  1 , Cécilia Landman  1   2 , Harry Sokol  1   2 , Laurent Beaugerie  1   2 , Jacques Cosnes  1   2 , Philippe Seksik  1   2 , Sarah Guégan  3   4 ; CD-HS Study Group
Affiliations

Increased risk of permanent stoma in Crohn's disease associated with hidradenitis suppurativa: a case-control study

Louis-Marie Dumont et al. Aliment Pharmacol Ther. 2020 Jul.

Abstract

Background: Crohn's disease (CD) and hidradenitis suppurativa (HS), a chronic inflammatory skin disease, induce similar inflammatory lesions of the groin and gluteal area. Both diseases are characterised by an inadequate immune response to commensal bacteria in genetically predisposed subjects and can be associated.

Aim: To assess whether HS was associated with clinical and prognostic factors in CD.

Methods: A retrospective case-control study included 4645 patients with CD referred to Saint-Antoine Hospital gastroenterology tertiary care centre between 2003 and 2016. Matching variables were sex, age, age and the presence of perianal lesions at CD diagnosis, follow-up quality. HS was confirmed by dermatological examination; location, phenotype and severity (Hurley staging) were recorded.

Results: Hidradenitis suppurativa prevalence was 0.95% (44 cases); 80% of patients displayed Hurley stage II or III disease. CD preceded HS in 70% of cases with a median interval of 9 years (IQR 5.25-12.75). CD with HS was more active (56% vs 40% years with active disease, P < 0.001) and required more anti-TNF agents (39% vs 23% years spent with anti-TNF treatment, P < 0.001) than CD without HS. HS was associated with a higher risk of permanent stoma, 16.8% (IQR 7.5-33.3) vs 2.5% (IQR 0.8-7.4) in the control group (P = 0.002). Multivariate analysis confirmed HS as independent risk factor for permanent stoma (odds ratio 6.19; 95% CI, 2.30-38.33; P < 0.001).

Conclusions: Hidradenitis suppurativa is associated with worse CD prognosis, more active disease and increased risk of permanent stoma, despite a higher use of anti-TNF agents.

Keywords: Crohn's disease; anti-tumour necrosis factor alpha; hidradenitis suppurativa; inflammatory bowel disease; stoma.

PubMed Disclaimer

References

REFERENCES

    1. Beaugerie L, Seksik P, Nion-Larmurier I, Gendre J-P, Cosnes J. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650-656.
    1. Hughes LE. Surgical pathology and management of anorectal Crohn’s disease. J R Soc Med. 1978;71:644-651.
    1. Vermeire S, Van Assche G, Rutgeerts P. Perianal Crohn’s disease: classification and clinical evaluation. Dig Liver Dis. 2007;39:959-962.
    1. Gionchetti P, Dignass A, Danese S, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: Part 2: surgical management and special situations. J Crohns Colitis. 2017;11:135-149.
    1. Tang LY, Rawsthorne P, Bernstein CN. Are perineal and luminal fistulas associated in Crohn’s disease? A population-based study. Clin Gastroenterol Hepatol. 2006;4:1130-1134.

Substances

LinkOut - more resources