Comorbidities and associated disease

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19/01/2026

Follicular diseases

Follicular diseases can precede the first symptoms of HS by several years:

• pilonidal sinus
• dissecting cellulitis of the scalp
• acne
• acne conglobata
• …

Inflammatory diseases

Digestive tract or rheumatism inflammatory diseases can be associated, justifying systematic investigation of symptoms associated with the following pathologies during patient interviews:

• asthenia;
• weight loss;
• back or peripheral articulation pain/stiffness inflammatory schedule (mornings);
• swelling of peripheral articulations;
• sciatica or alternating buttock pain;
• talalgia;
• sternal pain in inflammatory rheumatism;
• stomach pain, associated with fever or not;
• blood or mucus in stool;
• diarrhoea in chronic inflammatory bowel diseases.

Skin cancers

A few observational studies have highlighted a higher prevalence of epidermoid skin cancer in patients with HS (approximately 4 times greater risk of developing an epidermoid carcinoma, regardless of anatomical location).

Cardiovascular diseases

Different epidemiological studies suggest that there is an elevated risk of cardiovascular disease in patients with HS (especially in severe cases) and of an associated metabolic syndrome (including obesity, dyslipidemia, diabetes or high blood pressure).

Metabolic syndrome

The patient should be referred to a specialist in case of doubt.

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