Advanced Hidradenitis Suppurativa Increasingly Associated with cSCC

According to new study results, advanced hidradenitis suppurativa (HS) is increasingly correlated with cutaneous squamous cell carcinoma (cSCC). HS is a chronic inflammatory skin disease that is associated with the development of painful abscesses, painful nodules, and pus-discharging sinuses that are localized in the axillary, inguinal, gluteal, and perianal regions on the skin. Study results were discussed during a presentation at the 2024 American Academy of Dermatology (AAD) in San Diego, California, from March 8, 2024, to March 12, 2024.

Image credit: Lea | stock.adobe.com

Previously, HS was found to be associated with cSCC, although the research was limited by the small sample sizes that were enrolled. For this newer study, a cross-sectional analysis was conducted and included approximately 107 million admissions across the National Inpatient Sample (NIS) database. Patients with cSCC with or without HS during 2016 to 2018 were included, and the authors compared the number of admissions of cSCC with HS to the number of admissions without.

The results indicated that the number of admissions with HS had an unadjusted odds ratio of cSCC that was 6 times greater than the number of admissions without HS (OR = 6.21, 95% CI 4.18-9.21). When adjusted for age and sex, this increased to an odds ratio that was 13 times greater (aOR = 13.37, 95% CI 8.99-19.88).

Furthermore, patients with HS who developed cSCC were older (53 years vs 42 years of age; p < .0001), and more likely to be male (60.7% vs 39.5%; p < 0.05) and Black (48% vs 47%). The study also indicated that, compared with other cSCC admissions, individuals with concomitant HS were less likely to be White and less likely to have cSCC on areas exposed to the sun. In addition, patients with concomitant HS were also more likely to have the anal skin as well as other areas of the trunk affected by cSCC. Compared with other cSCC admissions, hospital charges and length of patients’ stay were greater in HS-associated cases of cSCC.

The investigators note that the study has some limitations, including the specificity of ICD codes that were derived from NIS (eg, “trunk”), as well as smoking and obesity not taken into consideration due to these factors missing from inpatient coding. Because advanced HS is increasingly correlated with cSCC and affects anatomically distinct areas in a younger and demographically diverse population. The authors note that early detection in patients with HS through the monitoring of patients—particularly Black male patients—at the age of 40 as well as examination via photo protected areas—such as the trunk and anal regions—are necessary to help reduce morbidity and mortality for this population.

Reference

Thakker, S, Samynathan, A, Bakshi, P, Hochman, E, Wikholm, C, and Pasieka, H. Hidradenitis Suppurativa-Associated Cutaneous Squamous Cell Carcinoma: A Cross-Sectional Analysis of the National Inpatient Sample. Presented Friday, March 8, 2024. Accessed March 8, 2024.