Hidradenitis Suppurativa Is Associated with Polycystic Ovary Syndrome: A Population-Based Analysis in the United States

Polycystic ovary syndrome (PCOS) has been linked to hidradenitis suppurativa (HS). However, evidence establishing a relationship between the two conditions is limited. We sought to determine the prevalence of PCOS among patients with HS and the strength of the association. We performed a cross-sectional analysis involving 22,990 patients with HS using clinical data from a multihealth system analytics platform comprising more than 55 million unique patients across all census regions of the United States. The prevalence of PCOS among patients with HS was 9.0%, compared with 2.9% in patients without HS (P < 0.0001). The likelihood of patients with HS having PCOS was 2.14 (95% confidence interval 2.04-2.24) times that of patients without HS, and PCOS was associated with HS across all subgroups. The strength of the HS association with PCOS was similar to that of diabetes mellitus (odds ratio 2.88, 95% confidence interval 2.83-2.93) and obesity (odds ratio 3.93, 95% confidence interval 3.87-3.99) with PCOS. The influence of disease severity on the strength of association with PCOS could not be assessed, nor could an HS phenotype for patients also having PCOS. This analysis could not establish directionality of relationship, nor causal link. In conclusion, PCOS is associated with HS, and patients with HS who have symptoms or signs of androgen excess should be screened for PCOS.