MUNICH -- Hidradenitis suppurativa is associated with a markedly increased risk of squamous cell carcinoma, Dr. JeanPaul Ortonne said at the 10th Congress of the European Academy of Dermatology and Venereology.
This chronic inflammatory skin disease may also be associated with increased risks of buccal and primary liver cancer, although this possibility needs to be interpreted with caution, said Dr. Ortonne of the National Institute of Health and Medical Research, Nice.
He cited as one of the most important clinical developments in dermatology over the past year a retrospective study by Dr. Jan Lapins and associates at Stockholm's Karolinska Institute. This was the first large-scale follow-up study of patients with hidradenitis suppurativa.
The investigators identified all 2,119 patients discharged with a diagnosis of hidradenitis suppurativa from any Swedish hospital during 1965-1997 and linked those records to the Swedish National Cancer Registry.
After excluding all cancers diagnosed within 1 year after hospitalization on the grounds that the malignancy might have predated the hidradenitis suppurativa, the Swedish investigators determined that patients with hidradenitis suppurativa were at 4.6-fold increased risk of subsequently developing squamous cell carcinoma. Women faced an 8.2-fold increase; for men, the increase was 1.7 fold (Arch.Dermatol. 137:730-34, 2001).
This study validates prior anecdotal reports suggesting a possible association between hidradenitis suppurativa and non-melanoma skin cancer, Dr. Ortonne said. The suspicion is that the chronic inflammatory bacterial infections and foreign body reactions that figure so prominently in hidradenitis suppurativa can trigger epidermal proliferative changes, including malignancy.
The higher skin cancer risk in women than men with hidradenitis suppurativa could be related to hormonal influences, or to the fact that women tend to get the inflammatory skin disease at an earlier age than men and hence have lengthier exposure to the disease's effects.
The Swedish study also demonstrated that patients with hidradenitis suppurativa were at 5.5-fold increased risk of buccal cancer and 10-fold elevated risk of primary liver cancer. However, there's no obvious pathophysiologic explanation for such an association, Dr. Ortonne said.