Is there a link between hidradenitis suppurativa and lupus?

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A 2018 case report notes the occurrence of HS in a person with well-established lupus. The authors also cite research that highlights cases of HS occurring alongside other autoimmune diseases, such as inflammatory bowel disease.

The authors suggest that the link between HS and autoimmune diseases means that the two conditions may share certain features or disease processes.

In a 2022 study, researchers used electronic health data to examine the past occurrence of autoimmune diseases in 627 people with HS.

For many of those people, treatment involved TNF inhibitors, which potentially contribute to the presence of certain autoantibodies and may lead to drug-induced lupus. Autoantibodies can also occur alongside inflammation.

The researchers found that the prevalence of autoimmune diseases was higher in people with HS than in those without. Lupus was one of the most common autoimmune diseases to occur in people with HS.

However, it is not clear whether the diagnosis of lupus was definite or whether the lupus-like laboratory findings were associated with treatments for HS.

The researchers also found that the prevalence of autoantibodies was higher in people with HS.

Autoantibodies are antibodies that the immune system mistakenly directs to attack healthy tissue, leading to inflammation and tissue damage. The presence of autoantibodies is a key marker of possible autoimmune diseases.

However, the researchers did not acknowledge a specific correlation between HS and autoimmune diseases or autoantibodies.

While the researchers do not consider HS an autoimmune disease, they suggest that it has similarities to autoimmune diseases and may have a link to inflammatory and autoimmune responses in the body.

The results of a 2020 study suggest that almost 4.1% of people in the United States may have HS.

Out of 4,303 people with HS, the researchers found a prevalence ratio of 1.91 for systemic lupus erythematosus (SLE). This suggests that SLE would be almost twice as likely to occur in people with HS than in those without HS.

However, certain HS treatments may influence a person’s autoantibody profile and could lead to drug-induced SLE. Further research is necessary to determine the exact link between HS and lupus and the prevalence of both conditions together.

According to a 2021 study, the overall prevalence of SLE in the United States from 2002 through 2009 was around 72.8 cases per 100,000 people.

HS and lupus may occur together. Researchers are still working to understand whether and why this happens, but the conditions may share certain features that cause their development.

A 2022 study found that people with HS have higher-than-usual autoantibody levels, which are also a key feature of autoimmune diseases such as lupus.

Researchers do not know the exact cause of HS, but it may link to autoimmune and inflammatory processes in the body. Certain factors relate to the occurrence of HS, including:

• family history of HS
• past or present tobacco use
• overweight or obesity
• metabolic syndrome

Lupus is an autoimmune disease. It occurs when the immune system mistakenly attacks healthy tissue. Researchers do not know why this happens, but the following factors may trigger this autoimmune response in the body:

• genes
• environmental factors, such as exposure to:
  • smoking
  • viruses
  • sunlight
  • certain medications
• inflammation or immune system problems, which may lead the immune system to attack itself

Learning the symptoms of these conditions can help a person tell HS and lupus apart and know the possible signs that they might be developing both conditions.

HS symptoms

HS usually affects areas of the body where skin is in contact with skin, such as the armpits and groin area. People may experience the following symptoms of HS in the affected area:

• discomfort or pain
• an acne-like spot that feels painful
• lumps
• swelling
• a burning sensation
• itching
• excessive sweating
• deep, tender nodules

As HS develops, symptoms can progress as follows:

• Lumps may join together and form painful abscesses.
• The fluid-filled lumps may break open and leak a foul-smelling mixture.
• Small black spots, which appear similar to blackheads, may form on the skin.
• Abscesses may heal and reopen, causing tunnels under the skin.
• Scars may form.

Lupus symptoms

Symptoms of lupus include:

• a butterfly-shaped rash across the nose and cheeks
• scaly, circular rashes on the body
• fatigue
• joint pain
• fevers
• sun sensitivity
• hair loss
• painless sores in the mouth and nose
• swollen glands
• skin discoloration on the fingers and toes, which may happen as a result of cold or stress
• abdominal pain
• swelling around the eyes or in the legs
• headaches
• dizziness
• confusion
• seizures
• pain when breathing deeply or when lying down

Lupus symptoms can affect each person differently, can come and go, and may be mild or more severe. Lupus can also affect the organs due to inflammation.

Although there is currently no cure for HS, treatment can help prevent the condition from worsening. Similarly, there is currently no cure for lupus, but treatment aims to manage the disease and may lead to remission.

For both conditions, people may undergo medical or alternative treatments to help manage pain. Healthcare professionals may also suggest counseling and support groups to help with mental health concerns.

HS treatment

Treatment for HS may include:

• a skin care plan, which may involve benzoyl peroxide washes and the use of mild antiperspirants
• proper wound care
• topical medications, such as:
  • antibiotics
  • resorcinol, a skin peel
• oral medications, such as:
  • antibiotics
  • retinoids, such as acitretin (Neotigason)
  • hormonal medication, such as birth control pills
  • biologics, such as adalimumab (Humira) or secukinumab (Cosentyx) and IL-17A inhibitor
• corticosteroid injections
• laser hair removal
• botulinum toxin, which can treat excessive sweating
• abscess draining
• laser surgery
• surgical procedures to treat tunnels in the skin

Lupus treatments

Treatment for lupus may include:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• antimalarials
• corticosteroids
• immunosuppressants
• B-lymphocyte stimulator (BlyS) protein inhibitor
• voclosporin (Lupkynis)
• type 1 interferon agents, such as anifrolumab (Saphnelo)

Lupus treatment may also involve treatment for other health conditions associated with lupus, such as high blood pressure.

People should speak with a doctor if they have any symptoms of HS or lupus. Treatment may help prevent HS or lupus from progressing and can help keep the conditions under control.

There may be a link between HS and lupus, which may make it more likely that a person will develop both conditions. If someone with HS or lupus has any symptoms of the other condition, they should contact a doctor.

HS is an inflammatory skin condition, and lupus is an autoimmune disease. These are two distinct conditions, and people may have one or both of them.

HS and lupus may have some similar features, including an increase in autoantibodies, and having one of these conditions may increase a person’s risk of developing the other. However, further research is necessary.

If people have any symptoms of HS or lupus, they should speak with a doctor. Treatment can help manage the symptoms and keep the conditions under control.