40194 Polycystic Ovary Syndrome Diagnosis Does Not Predict Increased Hidradenitis Suppurativa Disease Severity

Hidradenitis suppurativa (HS) is a painful inflammatory disorder of follicular biology. Androgens are believed to play a pathogenic role; however, normal sex hormone levels in most studies suggest the mechanism is end-organ hypersensitivity. Since polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and shows increased frequency in HS, we sought to explore the impact of PCOS on HS severity. We conducted a retrospective chart review of 112 female patients undergoing care at the Einstein/Montefiore HS Center between 2017 and 2022. Fifty-five (n=55) patients with PCOS and HS were compared to 57 patients with HS exclusively in the same cohort. Testing for statistical differences between the means of each group was performed by two-tailed t-test analysis. No statistical differences were found in age, sex, race, HS severity, testosterone levels, hemoglobin A1C, and inflammatory markers when comparing the HS/PCOS cohort and HS/controls. Additionally, no significant difference was found in the frequency at which core HS therapies were prescribed for PCOS versus non-PCOS patients (oral antibiotics, spironolactone, birth control, finasteride, adalimumab, infliximab, ertapenem, intra-lesional and intra-muscular triamcinolone injections). The likelihood of women with HS having PCOS is 2.14 (95% confidence interval 2.04-2.24) times that of patients without HS. In our study, the absence of significant differences in disease severity and testosterone levels between HS/PCOS and HS/control groups suggests that PCOS does not forecast a poor prognosis. Small sample size and variation in treatment algorithms are potential study limitations, but our findings underscore the need for more rigorous studies of hormonal therapy.