Risk of Alopecia areata and Lichen planopilaris increased in Patients with Hidradenitis Suppurativa

New study Identifies Increased Risk of Autoimmune Hair Loss in Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a dermatological condition that is associated with painful draining lumps in the underarm area (axillae), groin area and buttocks and under the breast. The lay public often refers to such lumps as boils - and patients affected by hidradenitis often describe their disease as one of multiple draining boils in the armpits, groin and buttocks regions. The condition can be emotionally and physically disabling.

Association of HS with Several Hair Loss Conditions

For years, it has been appreciated that there is a close relationship between HS and the scarring alopecia dissecting cellulitis. A new study points out that patients with HS are also at risk to develop alopecia areata and lichen planopilaris.

Researchers at Penn Sate Milton S Hershey Medical Center in Hershey, Pennsylvania studied 3645 patients with HS and compared the findings to 36, 450 matched controls. The researchers showed that patients with HS were at increased risk (relative risk 2.22) to develop alopecia areata (including totalis and universalis) compared to the control group. Interestingly, there was also an increased risk of lichen planopilaris (relative risk 1.54).

Comment

This was an interesting study and helps us to understand that alopecia, LPP dissecting cellulitis and hidradenitis share more in common than perhaps we once realized. This data would suggest that these diseases all share in common a central role of the hair follicle as an target of the initial inciting event. These disease probably have some common inflammatory pathways shared.

This data is an important as research in hidradenitis is at an all time high and the condition is being studied and discussed by dermatologists at a rate never seen before. Advances in treatments for HS may provide some help to how we go about treating alopecia areata and lichen planopilaris. Confirmation of this awaits further studies.

Reference

Horissian M et al. Increased risk of alopecia areata for people with hidradenitis suppurativa in a cross-sectional study. J Am Acad Dermatol 2019