Correlation Identified Between Complete Blood Count Parameters, HS Severity

New findings suggest complete blood count (CBC)-derived parameters such as red blood cell (RBC) count and increased platelet count are distinct in patients with hidradenitis suppurativa (HS), suggesting they may represent more accessible markers of HS-related activity.1

These new data, supporting the utilization of routine hematologic markers as potential indicators of systemic inflammation in those with HS, were authored by such investigators as Zeinab Aryanian, MD, of Tehran University of Medical Sciences. Aryanian and coauthors conducted a cross-sectional analysis, during which they looked at whether commonly obtained CBC markers, including red and white blood cell measurements and derived inflammatory ratios, differed between patients living with HS and healthy controls.

“By elucidating these relationships, we hope to advance the understanding of systemic inflammation in HS and support the development of reliable biomarkers for individualized patient care,” the investigative team wrote.1

Which CBC Parameters Were Assessed in Patients with HS?

In addition to evaluating the aforementioned differences between patients and controls, the investigators also assessed whether these results showed a link with HS severity, staging, and patient demographic characteristics. Aryanian et al noted prior research had pointed to CBC parameters, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as possible biomarkers of systemic, HS-related inflammation.2

In their study into CBC parameters, the investigators’ population consisted of 75 individuals with an HS diagnosis and 75 healthy control arm subjects. They looked into several CBC components, including platelet count, white blood cell (WBC) count, red blood cell (RBC) count, and inflammatory indices such as the NLR and PLR. Disease burden among those involved in the HS arm was evaluated via both staging criteria and Severity Assessment of Hidradenitis Suppurativa (SAHS) scores.

In their analysis of laboratory findings, Aryanian and colleagues demonstrated multiple statistically significant distinctions between individuals living with HS and those in the healthy cohort. Those with HS showed elevated RBC counts, platelet counts, and mean platelet volume (MPV) compared with controls. Additionally, the team identified lower values for red blood cell distribution width (RDW), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) among those with the skin disease. Such differences attained statistical significance, with reported P values ranging from .01 to less than .0001.

While there remains increasing interest in inflammatory ratios such as NLR and PLR as biomarkers in the chronic inflammatory disease space, the investigative team did not find any meaningful differences in either parameter between the HS cohort and the healthy comparison arm. In their statistical analysis, they showed no significant variation in NLR (P = .55) or PLR (P = .73), indicating these markers may have limited utility in distinguishing patients with HS from those unaffected by HS within this study population.

Aryanian et al further noted connections between certain hematologic results and patients’ level of HS severity. Higher RBC levels were linked with less severe manifestations of the disease, with the team suggesting a modest inverse correlation was observed between RBC count and disease severity scores. They also observed sex-based differences, with male subjects demonstrating significantly higher RBC and hemoglobin levels versus female subjects.

The investigative team described several CBC-related parameters, including RBC count, RDW, MCH, and MCV as warranting additional research as accessible and inexpensive biomarkers for monitoring inflammatory disease activity in those with HS. Given CBC testing’s routine implementation in clinical practice, such markers could eventually contribute to more individualized disease evaluations and strategies for treatment if validated in future data.

The authors cautioned, however, that these results should be interpreted within the context of their acknowledged limitations. The analysis involved a relatively small patient population and was conducted at a single center. Additionally, the cross-sectional design of the study limits the team’s ability to determine causality or look into how the laboratory markers may shift over time or in response to treatment.

“While many findings align with previous research, discrepancies in parameters such as RDW and NLR underscore the need for further investigation to understand HS-specific pathophysiological mechanisms, especially in different ethnic groups,” Aryanian and colleagues wrote.1 “Future research should focus on larger, more diverse cohorts and explore the utility of hematological markers in monitoring HS progression and treatment response.”

References

1. Z Aryanian, S Hamzelou, H Bazaz, et al. Evaluation of the Complete Blood Count (CBC) Parameters in Patients With Hidradenitis Suppurativa and Their Correlation With Disease Severity: A Cross-Sectional Study. Health Science Reports9 (2026): e72203. https://doi.org/10.1002/hsr2.72203.

2. Çetinarslan T, Türel Ermertcan A, Gündüz K, et al. Evaluation of the laboratory parameters in hidradenitis suppurativa: Can we use new inflammatory biomarkers? Dermatol Ther. 2021 Mar;34(2):e14835. doi: 10.1111/dth.14835. Epub 2021 Feb 11. PMID: 33527638.