Evaluation of systemic inflammatory biomarkers to determine severity and potential comorbidity risk in patients with Hidradenitis suppurativa

Aim: The aim of this study is to define the clinical severity of HS disease, which is accompanied by serious systemic comorbidities and complications, in relation to biomarkers, as well as their association with potential comorbidities and their possible role in treatment selection. Materials and Methods: The study included 66 patients of both genders diagnosed with Hidradenitis Suppurativa who presented to the Cerrahpaşa Medical Faculty Dermatology and Venereal Diseases clinic between November 1, 2022, and November 1, 2024. Clinical and laboratory findings were noted retrospectively, and the patients' laboratory markers, demographic characteristics, clinical features and severity staging data were categorized and analyzed for interrelations. Results: According to the correlation analysis between the Hurley stage and biomarkers, CRP, ESR, Serum Amyloid A, and Ceruloplasmin (each p < 0.001) demonstrated a significant positive correlation with the Hurley stage. Haptoglobin (p < 0.001), WBC (p = 0.011), neutrophils (p = 0.024), and SIII (p = 0.007) showed a statistically significant low positive correlation. The correlation of NLR with the Hurley stage was not found to be statistically significant (p = 0.101). The correlation of the PLR value exhibited borderline significance (p = 0.055). In examining the correlation of biomarkers with the IHS4 score, CRP, Serum Amyloid A, Ceruloplasmin, ESR, and haptoglobin (each p < 0.001) were found to show a significant positive correlation with the IHS4 score. The correlations of NLR (p = 0.002) and PLR (p = 0.024) were also found to be statistically significant at a low level. It was determined that as IHS4 severity increased, there was a significant rise in ceruloplasmin and haptoglobin levels (p < 0.001). SIII also showed a significant increase in the severe group (p = 0.002). It was determined that the PLR and PIV values were significantly higher in the group with severe IHS4 compared to other groups (p = 0.026, p = 0.040). CRP, ESR, and serum amyloid A levels were found to be significantly higher in the severe group (p < 0.001). In correlation analysis with the PGA score and biomarkers, Serum Amyloid A, CRP, Ceruloplasmin, Haptoglobin, and ESR (p < 0.001) values were found to show a significant positive correlation with the PGA score. There was no significant relationship between the PGA score and NLR (p = 0.367) or PLR (p = 0.080). Each unit increase in CRP level was found to increase the likelihood of an increase in the PGA score by 1.995 times. Haptoglobin, Ceruloplasmin, and SIII values did not have a significant effect on the PGA score. According to the correlation analysis between the DLQI score and biomarkers, Serum Amyloid A (p < 0.001), CRP (p < 0.001), ESR (p < 0.001), Ceruloplasmin (p < 0.001), and Haptoglobin (p < 0.001) values were found to have a significant positive correlation with the DLQI Score. NLR (p = 0.001) and PLR (p = 0.020) values were found to show a significant low to moderate positive correlation with the DLQI score. Conclusion: According to the results of this thesis study, CRP and ESR may be reliable biomarkers in determining the clinical severity of the disease, while SAA may play a potential role in treatment selection and prevention of complications. Haptoglobin and SIII levels may be associated with certain complications, but this relationship needs to be clarified through further research. NLR and PLR appear to have limited effectiveness in predicting disease severity based on current data. PIV is worth exploring as a promising biomarker for disease monitoring and the prevention of metabolic comorbidities. Future studies providing data that reinforce personalized treatment approaches may enable more effective use of these biomarkers in the management of Hidradenitis Suppurativa. Keywords: Hidradenitis Suppurativa, Disease Severity, Biomarkers, Systemic İnflammation, Serum Amyloid A, Haptoglobin