Supplementary Material for: Risk of Atopic Diseases in Patients with Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis of Observational Studies

Background Hidradenitis suppurativa (HS) and allergic diseases were considered to have different immune pathways involved. However, available evidences seemed to be inconsistent and the association was not well-developed yet. Objective To perform a systematic review and meta-analysis to evaluate the association between HS and atopic diseases, including asthma, atopic dermatitis, allergic rhinitis and conjunctivitis. Methods Search in databases including PubMed, Embase and Web of Science were performed. Synonyms were determined based on MeSH terms and Emtree. Observational studies with proper comparative arm were selected. For quality evaluation of extracted studies, the Newcastle-Ottawa Scale was utilized. Odds ratio of atopic dermatitis, asthma, allergic rhinitis and conjunctivitis were evaluated in HS patients (comparing with non-HS people). I2 value was applied to evaluate the heterogeneity within studies. Results After appraising 1,654 studies, in total, 12 studies were selected for data extraction. In adjusted models, people with HS is significantly associated with higher risk of having asthma, with a pooled odds ratio of 1.50 (95% CI, 1.24-1.81). Risk of presenting atopic dermatitis in HS patients was also increased, with an odd ratio of 4.10 (95% CI, 2.16-8.18). The association remained its significance in sensitivity models. Evidences were insufficient to support the association between HS and allergic rhinitis and conjunctivitis. Conclusion Current evidence supported that atopic dermatitis and asthma were associated with HS. Physicians should be aware of the reported association while caring people with HS and related screening of allergies comorbidities should be recommended.

【背景】化脓性汗腺炎（Hidradenitis suppurativa, HS）与过敏性疾病曾被认为涉及不同的免疫通路，但现有研究证据存在不一致性，二者间的关联尚未得到充分阐明。
【目的】本研究旨在开展系统综述与荟萃分析，评估化脓性汗腺炎与特应性疾病（atopic diseases）之间的关联，所纳入的特应性疾病包括哮喘、特应性皮炎、变应性鼻炎及结膜炎。
【方法】检索PubMed、Embase及Web of Science数据库，基于医学主题词表（MeSH terms）与Emtree主题词库确定同义词；筛选设有恰当对照的观察性研究；采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对纳入研究进行质量评价；以比值比（odds ratio, OR）评估化脓性汗腺炎患者相较于非化脓性汗腺炎人群的特应性皮炎、哮喘、变应性鼻炎及结膜炎发病风险；采用I²值评估研究间的异质性。
【结果】共检索并评估1654项研究，最终纳入12项研究进行数据提取。在校正模型中，化脓性汗腺炎患者发生哮喘的风险显著升高，合并比值比为1.50（95%置信区间：1.24~1.81）；化脓性汗腺炎患者的特应性皮炎发病风险亦显著增加，合并比值比为4.10（95%置信区间：2.16~8.18）。敏感性分析结果显示该关联具有稳健性。现有证据不足以支持化脓性汗腺炎与变应性鼻炎及结膜炎之间存在关联。
【结论】现有证据表明，特应性皮炎、哮喘与化脓性汗腺炎存在关联。临床医师在诊疗化脓性汗腺炎患者时应警惕该关联，并推荐对患者开展过敏性共病的相关筛查。