Does Hidradenitis Suppurativa cause skin cancer?

April 1, 2019

Christen Samaan, MD, Joslyn Kirby, MD, MS, MEd; Penn State University/Milton S Hershey Medical Center

Paper citation: Kohorst JJ, Shah KK, Hallemeier CL, Baum CL, Davis MDP. Squamous Cell Carcinoma in Perineal, Perianal, and Gluteal Hidradenitis Suppurativa: Experience in 12 Patients. Dermatol Surg. 2019;45(4):519-526. 

Chapman S, Delgadillo D III, Barber C, Khachemoune A. Cutaneous squamous cell carcinoma complicating hidradenitis suppurativa: a review of the prevalence, pathogenesis, and treatment of this dreaded complication. Acta Dermatovenerol Alp Pannonica Adriat. 2018;27(1):25-28.

Longstanding Hidradenitis Suppurativa (HS) can be associated with other complications, such as intestinal problems and skin cancer. HS is an immune system disease that causes damage to the skin with wounds often persisting for years. However, not much is known about HS causing skin cancer.

Wait, HS is more than enough…what’s this about it causing skin cancer?

There have been reports over the years of HS causing skin cancer, especially in longstanding wounds. However, we do not know why certain people develop skin cancer and others do not. We know from other skin diseases that long-lasting injury to the skin and poor healing can lead to skin cancer, specifically a type called squamous cell cancer (SCC).

How often does HS cause skin cancer?

HS causing skin cancer is very rare. That is one reason why there is limited research for this topic. We would need to study thousands of patients with HS over several decades to know exactly how often it occurs. With the limited research that is available, the best estimate for how often HS causes skin cancer is 4.6% of cases. Even though the risk is low, studying the data we have can help us determine how we can avoid it.

Learn from those who had it happen…

Two groups of researchers looked back at cases where HS caused skin cancer. Looking back allows us to learn what increases the risk for skin cancer and how we can avoid it for others. One study reviewed 12 patients in their hospital. A second group of researchers studied 85 cases that were published in different medical journals.

Five risk factors for skin cancer in HS 

By reviewing these cases, the researchers found five factors that may contribute to skin cancer in HS. Risk is increased in:

• People who developed HS at a young age
• Male patients
• People with HS in the genitals and buttocks, especially perianal skin
• People who use tobacco, as it adds to the inflammation in the body and slows down skin healing
• People with long-standing HS lesions

Three things you can do

Even though HS causing skin cancer is rare, preventing this complication is important as the skin cancer can be aggressive.  We are able to control some of the factors that can increase the risk of skin cancer. Regular skin checks are important to watch for new or worsening HS lesions. Keep an eye on long-standing HS lesions, and evaluate any lesions that aren’t typical for you. Working with your Primary Care doctor on smoking cessation is important since smoking can increase inflammation and slow wounds from healing. Most importantly, continue to work with your Dermatologist to manage your HS and figure out the best treatment plan for you.

Photo by kevin turcios on Unsplash