Background: Hidradenitis suppurativa is a chronic inflammatory skin disease involving the axillary, inguinal and anogenital regions and sometimes, in addition, the submammary or sacral areas. The etiology of this condition is unknown. Objective: A matched-pair case-control study was performed to evaluate the influence of smoking habits on the manifestation of this disease. Methods: Patients who had received surgical treatment for hidradenitis suppurativa in two dermatological centers completed a questionnaire dealing with family history, course of the disease and smoking habits. To form a randomized matched-pair control group, an equal number of patients admitted for various other skin diseases such as atopic dermatitis, varicose veins, skin tattoos, alopecia areata or melanoma was matched for sex and age and evaluated for smoking habits. Statistical analysis was performed by use of several χ2 tests in a cross-table setting. Moreover, a comparison to the expected smoking prevalence in Germany based on national statistics was performed. Results: Out of 84 patients treated for hidradenitis suppurativa, 63 subjects (27 men, 36 women) completed the questionnaire. The rate of active cigarette smokers was 88.9% (56 patients), whereas 4 subjects (6.4%) had never smoked. 3 patients (4.8%) stated to be ex-smokers, but 2 of these had quit smoking only recently and after onset of the disease. The rate of smokers in the matched-pair control group was 46%. The significantly higher proportion of active smokers among patients with hidradenitis suppurativa can be expressed by an odds ratio of 9.4, the calculated 95% confidence interval was 3.7–23.7 (p < 0.001). The expected smoking prevalence in Germany was 26.7% according to national statistics. 73% of our patients had no family history of hidradenitis suppurativa whereas 27% reported at least one affected first-degree relative. Conclusion: From the exceedingly high rate of smokers among patients with this condition we conclude that cigarette smoking is a major triggering factor of hidradenitis suppurativa. Remarkably, the disease can be categorized as a smoking sequel that is neither of vascular nor neoplastic nature. Because familial occurrence was rather rarely reported, and because an environmental factor in the form of cigarette smoking appears to be of crucial importance to trigger the disease, we assume that the genetic basis of hidradenitis suppurativa is polygenic rather than mendelian. Smoking cessation should be encouraged particularly in patients with hidradenitis suppurativa although it is unknown whether this improves the course of the disease.
Dr. Arne König
Dermatologische Klinik, Philipps-Universität
Deutschhausstrasse 9, D–35033 Marburg (Germany)
Tel. +49 6421 282900, Fax +49 6421 282898
Received: Received: November 21, 1998
Accepted: January 24, 1999
Number of Print Pages : 4
Number of Figures : 1, Number of Tables : 1, Number of References : 15
Dermatology (International Journal for Clinical and Investigative Dermatology)
Founded as ‘Dermatologische Zeitschrift’ by Oskar Lassar (1893–1907); Continued by Erich Hoffmann (1908–1938), continued as ‘Dermatologica’ (1939–1991), by Wilhelm Lutz (1939–1958), Rudolf Schuppli (1959–1985)
Official Organ of the Swiss Society for Dermatology and Venereology; Official Organ of the Belgian Royal Society for Dermatology and Venereology
Vol. 198, No. 3, Year 1999 (Cover Date: 1999)
Journal Editor: J.-H. Saurat, Geneva.
ISSN: 1018–8665 (print), 1421–9832 (Online)
For additional information: http://www.karger.com/journals/drm
Article / Publication Details
Published online: 6/17/1999
Issue release date: 1999
Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1
ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)
For additional information: http://www.karger.com/DRM
Copyright / Drug Dosage
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.