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Henning MAS, Didriksen M, Ibler KS, Ostrowski SR, Erikstrup C, Nielsen K, Sækmose SG, Hansen TF, Ullum H, Thørner LW, Kaspersen KA, Mikkelsen S, Jemec GBE, Pedersen OB. The differentiating effect of COVID-19-associated stress on the morbidity of blood donors with symptoms of hidradenitis suppurativa, hyperhidrosis, or psoriasis. Qual Life Res 2023; 32:2925-2937. [PMID: 37270451 PMCID: PMC10239219 DOI: 10.1007/s11136-023-03448-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE The burden of different skin diseases may vary leading individuals to have different sensitivity to stress. Therefore, we compared the health-related quality of life (HRQoL) and stress before and during the universal stress from the severe acute respiratory syndrome coronavirus-2-pandemic in individuals with and without hyperhidrosis, hidradenitis suppurativa, or psoriasis. METHODS The study cohort was the Danish Blood Donor Study. Overall, 12,798 participants completed a baseline questionnaire before the pandemic, in 2018-2019, and a follow-up questionnaire during the pandemic, in 2020. Regression determined the association between the skin diseases and outcomes. Outcomes were the physical and mental component summary (MCS, PCS, respectively), which assess the mental and physical HRQoL, and the perceived stress scale, which assesses stress in the past four weeks. RESULTS Overall, 1168 (9.1%) participants had hyperhidrosis, 363 (2.8%) had hidradenitis suppurativa, and 402 (3.1%) had psoriasis. At follow-up, the participants with hyperhidrosis had worse MCS (coefficient -0.59 [95% confidence interval (CI) -1.05, -0.13]) and higher odds of moderate-to-severe stress (odds ratio 1.37 [95% CI 1.13, 1.65]) and the participants with hidradenitis suppurativa worse PCS (coefficient -0.74 [95% CI -1.21, -0.27]) than the control groups. The associations were independent of baseline HRQoL, stress, the Connor-Davidson Resilience scale, and other covariables. Psoriasis was not associated with the outcomes. CONCLUSION Individuals with hyperhidrosis or hidradenitis suppurativa experienced worse mental or physical well-being and individuals with hyperhidrosis also had higher stress during the pandemic compared to healthy individuals. This suggests that individuals with these skin diseases are particularly susceptible to external stress.
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Affiliation(s)
- M A S Henning
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
| | - M Didriksen
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - K S Ibler
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - S R Ostrowski
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - K Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - S G Sækmose
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - T F Hansen
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Neurology, Danish Headache Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - H Ullum
- Statens Serum Institute, Copenhagen, Denmark
| | - L W Thørner
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - K A Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark
| | - S Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
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Henning M, Ibler K, Loft I, Jennum P, Didriksen M, Ullum H, Erikstrup C, Nielsen K, Bruun MT, Hjalgrim H, Sørensen E, Dinh K, Thørner LW, Jemec GB, Pedersen O. Hyperhidrosis is associated with sleep disturbances, daytime tiredness, stress, and depression: A retrospective cohort study from the Danish Blood Donor Study. J Am Acad Dermatol 2023; 88:196-197. [PMID: 35427682 DOI: 10.1016/j.jaad.2022.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Mattias Henning
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Kristina Ibler
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Isabella Loft
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Copenhagen University Hospital, Glostrup, University of Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Denmark
| | - Henrik Ullum
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Kaspar Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Denmark
| | - Henrik Hjalgrim
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Haematology, Copenhagen University Hospital Rigshospitalet, Denmark; Department of Medicine, Copenhagen University, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Denmark
| | - Khoa Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Denmark
| | | | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ole Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
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Henning M, Reguant R, Jørgensen I, Andersen R, Ibler K, Pedersen O, Jemec G, Brunak S. The temporal association of hyperhidrosis and its comorbidities - a nationwide hospital-based cohort study. J Eur Acad Dermatol Venereol 2022; 36:2504-2511. [PMID: 35735049 PMCID: PMC9796903 DOI: 10.1111/jdv.18351] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/05/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Research on hyperhidrosis comorbidities has documented the co-occurrence of diseases but has not provided information about temporal disease associations. OBJECTIVE To investigate the temporal disease trajectories of individuals with hospital-diagnosed hyperhidrosis. METHODS This is a hospital-based nationwide cohort study including all patients with a hospital contact in Denmark between 1994 and 2018. International Classification of Diseases version-10 diagnoses assigned to inpatients, outpatients and emergency department patients were collected from the Danish National Patient Register. The main outcome was the temporal disease associations occurring in individuals with hyperhidrosis, which was assessed by identifying morbidities significantly associated with hyperhidrosis and then examining whether there was a significant order of these diagnoses using binomial tests. RESULTS Overall, 7 191 519 patients were included. Of these, 8758 (0.12%) patients had localized hyperhidrosis (5674 female sex [64.8%]; median age at first diagnosis 26.9 [interquartile range 21.3-36.1]) and 1102 (0.015%) generalized hyperhidrosis (606 female sex [59.9%]; median age at first diagnosis 40.9 [interquartile range 26.4-60.7]). The disease trajectories comprised pain complaints, stress, epilepsy, respiratory and psychiatric diseases. The most diagnosed morbidities for localized hyperhidrosis were abdominal pain (relative risk [RR] = 121.75; 95% Confidence Interval [CI] 121.14-122.35; P < 0.001), soft tissue disorders (RR = 151.19; 95% CI 149.58-152.80; P < 0.001) and dorsalgia (RR = 160.15; 95% CI 158.92-161.38; P < 0.001). The most diagnosed morbidities for generalized hyperhidrosis were dorsalgia (RR = 306.59; 95% CI 302.17-311.02; P < 0.001), angina pectoris (RR = 411.69; 95% CI 402.23-421.16; P < 0.001) and depression (RR = 207.92; 95% CI 202.21-213.62; P < 0.001). All these morbidities were diagnosed before hyperhidrosis. CONCLUSIONS This paper ascertains which hospital-diagnosed morbidities precede hospital-diagnosed hyperhidrosis. As hyperhidrosis mainly is treated in the primary health care sector, the trajectories suggests that these morbidities may lead to a worse disease course of hyperhidrosis that necessitates treatment in hospitals. Treating these morbidities may improve the disease course of hyperhidrosis.
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Affiliation(s)
- M.A.S. Henning
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - R. Reguant
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| | - I.F. Jørgensen
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| | - R.K. Andersen
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - K.S. Ibler
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - O.B. Pedersen
- Department of Clinical ImmunologyZealand University HospitalKøgeDenmark
| | - G.B.E. Jemec
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - S. Brunak
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
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Henning MAS, Bouazzi D, Jemec GBE. Treatment of Hyperhidrosis: An Update. Am J Clin Dermatol 2022; 23:635-646. [PMID: 35773437 DOI: 10.1007/s40257-022-00707-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Abstract
Hyperhidrosis is a dermatosis presenting as pathologically excessive focal or generalized sweating. The stigmatizing nature of hyperhidrosis may cause patients to feel embarrassment and apprehension about their symptoms and experience a significant decrease in well-being. Severe cases of hyperhidrosis can also increase the risk of developing psychiatric and somatic comorbidities. Conventional non-surgical treatments of hyperhidrosis include aluminum salts, iontophoresis, botulinum toxin injections, and oral glycopyrronium. In recent years, new topical anticholinergic medications and devices have emerged that may improve the patients' symptoms and even prevent the development of comorbidities. The treatment of hyperhidrosis can be a complex matter and may require the combination of several therapies. The purpose of this paper was to firstly review the literature on existing non-surgical treatment options for hyperhidrosis, and secondly provide a stepwise approach to investigating and treating patients with hyperhidrosis.
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Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Dorra Bouazzi
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
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Henning M, Hother CE, Banasik K, Ibler KS, Ostrowski SR, Erikstrup C, Nielsen KR, Ullum H, Hjalgrim H, Hansen TF, Kaspersen KA, Sørensen BS, Saekmose SG, Jemec GBE, Pedersen OB. Hyperhidrosis and human leucocyte antigens in the Danish Blood Donor Study. Scand J Immunol 2022; 95:e13150. [PMID: 35212011 DOI: 10.1111/sji.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/31/2022] [Indexed: 11/26/2022]
Abstract
Familial clustering of the skin disease primary hyperhidrosis suggests a genetic component to the disease. The human leucocyte antigen (HLA) is implicated in a range of diseases, including many comorbidities to hyperhidrosis. No study has investigated whether the HLA genes are involved in the pathogenesis of hyperhidrosis. We, therefore, compared HLA alleles in individuals with and without hyperhidrosis in this study of 65,000 blood donors. In this retrospective cohort study, we retrieved information on individuals with and without hyperhidrosis using self-reported questionnaires, the Danish National Patient Registry and the Danish National Prescription Registry on participants recruited to the Danish Blood Donor Study between 2010 and 2019. Association tests using logistic regression were conducted for each HLA allele corrected for sex, age, body mass index, smoking and principal components. Overall, 145 of 65,795 (0.2%) participants had hospital diagnosed hyperhidrosis. Similarly, 1,379 of 15,530 (8.9%) participants had moderate-severe self-reported hyperhidrosis, of whom 447 (2.9%) had severe self-reported hyperhidrosis. Altogether 28 participants had both hospital diagnosed and moderate-severe self-reported hyperhidrosis. Severe self-reported hyperhidrosis was associated with HLA-A*80:01 (adjusted odds ratio 26.97; 95% confidence interval 5.32-136.70; n=7; p<0.001). Moderate-severe self-reported hyperhidrosis and hospital diagnosed hyperhidrosis were not associated with any HLA. The association between hyperhidrosis and HLA-A*80:01 was based on a very small number of cases and not replicated in other patient subsets, and therefore likely a chance finding. Thus, this study suggests that genes other than the HLA are involved in the pathogenesis of hyperhidrosis.
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Affiliation(s)
- Mattias Henning
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | | | - Karina Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-4000, Roskilde, Denmark
| | - Betina S Sørensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
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6
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The health-related quality of life in hyperhidrosis and co-morbidities. Qual Life Res 2022; 31:2331-2340. [DOI: 10.1007/s11136-022-03108-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
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7
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Henning MAS, Ibler KS, Ostrowski SR, Erikstrup C, Nielsen KR, Bruun MT, Hjalgrim H, Ullum H, Didriksen M, Dinh KM, Rostgaard K, Pedersen OB, Jemec GB. Hyperhidrosis and the risk of being treated for skin infections. J DERMATOL TREAT 2021; 33:2263-2269. [PMID: 34152896 DOI: 10.1080/09546634.2021.1944971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND A few studies have described an increased prevalence of skin infections in individuals with hyperhidrosis compared to others. However, it remains uncertain whether hyperhidrosis is an independent risk factor for skin infections. OBJECTIVE To compare the risk of skin infections in individuals with and without hyperhidrosis. METHODS In this retrospective cohort study, data on hyperhidrosis were collected from the Danish Blood Donor Study. Blood donors included in 2010-2019 were followed from inclusion until December 2019. Data on redeemed prescriptions against skin infections were collected from the National Prescription Register. The intensity of prescription-use by hyperhidrosis status was assessed in Andersen-Gill models. RESULTS Overall, 4,176 (9.6%) of 43,477 blood donors had self-reported hyperhidrosis and 437 (0.34%) of 127,823 blood donors had hospital diagnosed hyperhidrosis. Self-reported hyperhidrosis was associated with the use of antibiotic prescriptions (adjusted hazard ratio = 1.21; 95% confidence interval 1.00-1.45, p = 0.047). Hospital diagnosed hyperhidrosis was associated with the use of antibiotic (adjusted hazard ratio = 1.33; 95% confidence interval 1.03-1.68, p = 0.028) and topical antifungal prescriptions (adjusted hazard ratio = 1.43; 95% confidence interval 1.04-1.97, p = 0.027). CONCLUSIONS Hyperhidrosis is associated with the use of prescriptions for antibiotics and topical antifungals. This suggests a clinically relevant association between hyperhidrosis and skin infections.
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Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University, Aalborg, Denmark
| | - Mie T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Henrik Hjalgrim
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Haematology, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Khoa M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital. University of Copenhagen, Copenhagen, Denmark
| | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark
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