Association Between Exogenous Testosterone Use and New Diagnosis of Hidradenitis Suppurativa: A Case Series

This case series examined the association between exogenous testosterone use and new diagnoses of hidradenitis suppurativa (HS) over a 6-year period at a major academic center. Out of 27 patients who met the inclusion criteria, 3 developed new HS within 12 months of starting exogenous testosterone for hypogonadism or decreased sexual desire. All 3 patients were diagnosed with Hurley stage I HS, with an average time to diagnosis of approximately 10 months. The study suggests a potential link between exogenous testosterone and HS, possibly mediated by androgen effects on sebum production, insulin resistance, or microbiome changes. However, the small sample size and single-institution data limit the findings, highlighting the need for larger cohort studies to better understand the relationship between androgens and HS.