Beyond the Skin: Ocular Manifestations in Hidradenitis Suppurativa - A Systematic Review.

Abstract

PurposeTo systematically evaluate the spectrum of ocular manifestations associated with hidradenitis suppurativa (HS), including inflammatory eye diseases, corneal involvement, retinal alterations, epidemiologic associations, treatment approaches, and visual outcomes. Methods A systematic literature search was performed in PubMed, Web of Science, and Cochrane Library databases up to May 10, 2026, in accordance with PRISMA guidelines. Eligible studies reporting ophthalmic manifestations in HS patients were included. Case reports, case series, original articles, and research letters were analyzed. Study quality was assessed using Joanna Briggs Institute (JBI) checklists, Newcastle-Ottawa Scale (NOS), and National Heart, Lung, and Blood Institute (NHLBI) quality assessment tools according to study design. ResultsA total of 23 studies were included, comprising 12 case reports/case series and 11 original observational studies. Clinic-based observational studies primarily described inflammatory eye disease, ocular surface dysfunction, dry eye disease, and retinal microvascular alterations, whereas population-based database studies demonstrated increased epidemiologic associations with multiple ophthalmologic diseases. Corneal involvement represented the predominant manifestation in case-based reports and included interstitial keratitis, peripheral ulcerative keratitis, Mooren-type ulceration, corneal neovascularization, ectasia, descemetocele formation, and spontaneous corneal perforation. In addition, management may require topical or systemic corticosteroids, biologic agents, conventional steroid-sparing immunosuppressive therapies, and, in severe cases, cornea-preserving surgical procedures. ConclusionsHS is associated with a broad spectrum of ocular manifestations, particularly inflammatory disorders affecting the ocular surface and cornea, which may occasionally progress to vision-threatening complications. Current evidence suggests that HS-related systemic inflammation may contribute to ophthalmologic morbidity. Further prospective ophthalmology-focused studies are needed.