Bone health in women with hidradenitis suppurativa: addressing osteoporosis risks and management options.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by painful nodules and abscesses in intertriginous areas, predominantly affecting women. Persistent systemic inflammation and hormonal changes may contribute to reduced bone health and an increased risk of osteoporosis in this population. Objective: To highlight osteoporosis as an underrecognized comorbidity in women with HS and discuss contributing inflammatory, hormonal, and lifestyle-related risk factors that may predispose patients to bone compromise. Methods: A narrative review of the literature was conducted examining the relationship between HS, chronic inflammation, menopause-related estrogen decline, and osteoporosis risk. Additional contributory factors commonly associated with HS, including tobacco use, vitamin D deficiency, obesity, physical inactivity, and repeated corticosteroid exposure, were evaluated. Results: Systemic inflammation, hormonal decline, corticosteroid exposure, vitamin D deficiency, and reduced activity may contribute to increased osteoporosis risk in women with HS. Limitations: Current evidence evaluating osteoporosis risk specifically in patients with HS remains limited, and additional prospective studies are needed to better characterize prevalence, mechanisms, and screening recommendations. Conclusion: Bone health should be considered in women with HS, particularly those with severe or longstanding disease.