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P170 Clinical characteristics of inflammatory bowel disease associated to hydradenitis suppurativa

A. Gutiérrez Casbas1, R. Muñoz2, A. Rodríguez2, L. Sempere2, J.I. Cameo2

1Hospital General Universitario Alicante, Department of Gastroenterology- CIBERehd, Alicante, Spain, 2, Gastroenterology, Alicante, Spain

Background

Hydradenitis suppurativa (HS) is a chronic inflammatory skin disorder of the hair follicle characterised by recurrent, painful nodules, abscesses, and sinus tracts. A clinical association between HS and inflammatory bowel disease (IBD), especially Crohn’s disease (CD), has been described in several previous observational studies.The etiology of both diseases is complex and largely unknown, but it appears that the mechanisms behind these diseases are multifactorial, caused by an interaction of genetic and environmental factors, and characterised by a dysregulated local immune response.

Methods

Aims: We performed a retrospective study to further characterise IBD patients diagnosed with HS in a single center.

Methods: A total of 23 patients with well established HS and IBD were identified in our center. Clinical and demographic relevant characteristics were obtained through extensive review of the health records. Each case of HS was confirmed by a dermatologist and was characterised by its location and Hurley’s classification.

Results

We included 23 patients diagnosed with HS and IBD (56,5% women, mean age 27,09 ± 11,17 years and 69,6% were diagnosed with CD). Montreal classification of CD patients was: L1: 31,3% and L2 -L3 62,6%; B1 87,5%, B2 12,5% and B3 12,5%. A total of 11 patients had been operated related to IBD: 7 (63,6%) for perianal disease and 4(36,6%) underwent bowel resection. The most common localisations affected by HS were axillary 11 (47,8%), inguinal 6 (26%), perianal 1 (4,3%), inguinal plus perianal 1 (4,3%), axillary plus inguinal 1 (4,3%), axillar plus perianal plus submammary 1 (4,3%) and scrotum 1 (4,3%). Patients were divided by Hurley’s classification into three categories: 10 (43,5%) as Hurley I, 11(47,8%) Hurley II and 2(8,7%) Hurley III. A total of 14 patients (60,9%) underwent surgery related to HS. Eleven patients (47,8%) were current smokers, 3(13%) former smokers and 9 (39,1%) non-smokers. Thirty percent of the patients had overweight. Seven patients (30%) were treated with antiTNF and 3(13%) with ustekinumab.

Conclusion

Overweight and smoking, risks factors shared by patients with HS and IBD, are presented in 30–50% of our series of patients. HS is more frequent in CD patients with colonic and perianal involvement. This association should be taken into account in IBD patients with these clinical characteristics due to its implication in differential diagnosis of perianal CD and in choosing effective therapy for both conditions.