Hidradenitis suppurativa: comorbidities to screen for
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Known hidradenitis suppurativa: screen for metabolic comorbidities
Fasting laboratory tests
- Fasting plasma glucose
- Lipid profile
Only if superinfection suspected
- Bacteriological sample of pus (if fever or cellulitis around the lesions)if needednon-French guidelineCulture is not recommended in routine practice, except for signs of secondary infection such as peripheral cellulitis or fever [2].
Do not order
- Routine bacteriological sampling of lesions: the cultured flora is mostly commensal and culture is not recommended outside superinfection (cellulitis, fever) [2].
- CRP, ESR or other blood markers for diagnosis: no current place for biomarkers or genetic tests [2].
- Routine TSH: insufficient evidence to recommend screening for thyroid disease [3].
- Faecal calprotectin to screen for Crohn's disease: value debated in adults, as it also rises with hidradenitis activity [6]; NABM coverage limited to known IBD, on prescription from a gastroenterologist or paediatrician [7].
- HbA1c to look for diabetes: NABM coverage limited to monitoring of glycaemic control [7]; use fasting plasma glucose.
Sources (7)
- Bertolotti A, Sbidian E, Join-Lambert O, Bourgault-Villada I, Moyal-Barracco M, Perrot P, et al.; Centre of Evidence of the French Society of Dermatology. Guidelines for the management of hidradenitis suppurativa: recommendations supported by the Centre of Evidence of the French Society of Dermatology. Br J Dermatol. 2021;184(5):963-5.
- Alikhan A, Sayed C, Alavi A, Alhusayen R, Brassard A, Burkhart C, et al. North American clinical management guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations. Part I: diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol. 2019;81(1):76-90.
- Garg A, Malviya N, Strunk A, Wright S, Alavi A, Alhusayen R, et al. Comorbidity screening in hidradenitis suppurativa: evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations. J Am Acad Dermatol. 2022;86(5):1092-101.
- Martorell Calatayud A, Alfageme Roldán F, García-Martínez FJ, Molina Leyva A, Pascual Ramírez JC, Vilarrasa E. Spanish Clinical Management Guideline for Hidradenitis Suppurativa. Part I: Pathogenesis, Diagnosis, and Disease Staging. Actas Dermosifiliogr. 2026;117(7):104639.
- Naik HB, Yeung H, Frazer-Green L, Daveluy SD, Garg A, McMichael AJ, et al. Joint American Academy of Dermatology-Hidradenitis Suppurativa Foundation guidelines of care for the management of hidradenitis suppurativa. J Am Acad Dermatol. Publié en ligne le 20 octobre 2026.
- Zouboulis CC, Bechara FG, Benhadou F, Bettoli V, Bukvić Mokos Z, Del Marmol V, et al. European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment. J Eur Acad Dermatol Venereol. 2025;39(5):899-941.
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : actes 1684 (calprotectine fécale) et 1577 (HbA1c).