The Second to Fourth Digit Ratio in Patients with Hidradenitis Suppurativa

Year 2023, Volume: 2 Issue: 1, 9 - 14, 30.03.2023

Melis Gönülal Didem Altıner Aylin Öztürk Kenan Teker Sinan Doğan Meltem Turkmen

https://doi.org/10.57221/izmirtip.1216588

Abstract

Amaç: Hidradenitis süpürativa (HS), kronik, tekrarlayan ve kıl foliküllerini, ter bezlerini tutan inflamatuar bir deri hastalığıdır. Androjenler ve 2.-4. parmak oranı (2D:4D) arasındaki bağlantıya dayanarak ve ayrıca seks hormonları ve HS arasındaki ilişki gözönünde bulundurulduğunda dolaylı olarak HS ve 2D:4D oranı arasında bir ilişki olabilir hipotezi kurulabilir. Bu çalışmanın amacı HS ve 2D:4D oranı arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Total testosteron ve dehidroepiandrosteron-sülfat (DHEA-S) seviyeleri hem erkek hem de kadın vakalarda ve kontrollerde ölçüldü. Luteinize edici hormon (LH), folikül uyarıcı hormon (FSH), LH/FSH oranı, estradiol, progesteron ve prolaktin seviyeleri sadece kadın olgularda ve kontrollerde analiz edildi. 2D:4D oranı ikinci parmak uzunluğunun dördüncü parmak uzunluğuna bölünmesi ile hesaplandı. Bulgular: Çalışma süresi boyunca 108 hastaya HS tanısı kondu. Bu hastaların 80'i (39’u kadın) çalışmaya alındı ve çalışma grubunu oluşturdu. Kontrol grubu 70 sağlıklı kişiden (35’i kadın) oluştu. Ağırlık, vücut kitle indeksi, sigara içme durumu, sigara içme süresi ve sol elin 2.-4. parmak uzunluğu arasında anlamlı ilişki hem kadın vakalarda hem de kontrollerde mevcuttu. Aynı anlamlı ilişki erkek cinsiyet ve kontrol gruplarında da mevcuttu. Kadın cinsiyette DHEA-S ile sağ el 2.-4. parmak uzunluğu ve sol el 2. parmak uzunluğu arasında anlamlı ilişki mevcuttu. Erkek cinsiyette hastalık başlangıcı ile sağ-sol el 2.-4. parmak uzunluğu oranı, hastalık süresi ve sağ el 4. parmak, sol el 2. parmak, DHEA-S ve sağ el 4. parmak- sol el 2. parmak uzunluğu arasında anlamlı ilişki mevcuttu. Sonuç: Bu çalışmanın HS, dolaşımdaki hormonlar ve 2.-4. parmak uzunluğu arasındaki oranı araştıran ilk çalışma olması nedeni ile önemli olduğu kanısındayız. Daha fazla hastada, ileri dönük çalışmaların yapılmasının yararlı olacağı düşüncesindeyiz.

Keywords

Hidradenitis süpürativa, 2D:4D, hormon

The Second to Fourth Digit Ratio in the Patients with Hidradenitis Suppurativa

Abstract

Aim: Hidradenitis suppurativa (HS) is a chronic, recurrent, and inflammatory skin disease involving the hair follicles and sweat glands. Based on the link between androgens and the second to fourth digit ratio (2D:4D) and also the connection between sex hormones and HS, it can be stated that there is an association between HS and the 2D:4D ratio. Based on this hypothesis, the present study investigated the relationships between HS, the 2D:4D ratio, and sex hormones. Materials and methods: Total testosterone and dehidroepiandrosteron-sulfate (DHEA-S) levels were measured in both male and female cases and controls. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio, estradiol, progesterone, and prolactin levels were analyzed in only female cases and controls. The 2D:4D ratio was calculated by dividing the second finger's length by the fourth finger's length. Results: One hundred eight patients were diagnosed with HS. Eighty of these patients (39 female) were enrolled and constituted the study group. The control group consisted of 70 healthy participants (35 female). There were significant associations between weight, body mass index, smoking status, duration of smoking, and the length of left 2D and left 4D in both female cases and controls. We also found significant relationships between body mass index, smoking status, duration of smoking, and total testosterone in male cases and controls. In female cases, we determined significant correlations between the length of the DHEA-S and 2D right, 4D right and 2D left. In male patients there were significant associations between age of disease onset and right 2D:4D, age of disease onset and left 2D:4D, disease duration and right 4D length, disease duration and left 2D length, DHEA-S and right 4D length, DHEA-S and left 2D length. Conclusion: We suggest that our research is a valuable contribution to the literature since it is the first study assessing the relationships between the 2D:4D ratio, HS and circulating hormone levels. However, further prospective studies, including larger patient samples, are required to identify relationships between the 2D:4D ratio and HS.

Keywords

Hidradenitis süpürativa, 2D:4D, hormone

References

• Referans1. Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158-64.
• Referans2. Chen W, Plewig G. Should hidradenitis suppurativa/acne inversa best be renamed as “dissecting terminal hair folliculitis”? Exp Dermatol. 2017;26(6):544-47.
• Referans3. Revuz JE, Canoui-Poitrine F, Wolkenstein P, Viallette C, Gabison G, Pouget F et al. Prevalence and factors associated with hidradenitis suppurativa: Results from two case-control studies. J Am Acad Dermatol. 2008;59: 596-601.
• Referans4. Chu CB, Yang CC, Tsai SY. Hidradenitis suppurativa: Disease pathophysiology and sex hormones. Chin J Physiol. 2021;64(6):257-65.
• Referans5. Unal M, Urun Unal G, Balevi S, Tol H, Uyar M. The second to fourth digit ratio in acne vulgaris. Pediatr Dermatol. 2015;32(5):651-5.
• Referans6. Manning JT. Resolving the role of prenatal sex steroids in the development of digit ratio. Proc Natl Acad Sci. 2011;108: 16143–4.
• Referans7. Bilgiç Ö, Altınyazar C, Hıra H, Doğdu M. Investigation of the association of the second-to-fourth digit ratio with skin sebum levels in females with acne vulgaris. Am J Clin Dermatol. 2015;16(6):559-64
• Referans8 .Lee EY, Alhusayen R, Langsang P, Shear N, Yeung J. What is hidradenitis suppurativa? Can Fam Physician. 2017;63(2):114-20.
• Referans9. Sartorius K, Emtestam L, Jemec GB, Lapins J. Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol. 2009; 161 (4):831-9.
• Referans10. Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD. Incidence ofhidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133(1):97-103.
• Referans11. Margesson LJ, Danby FW. Hidradenitis suppurativa. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1013-27.
• Referans12. Buonomo M, Mansh MD,Thorpe D, Goldfarb N. Development or exacerbation of hidradenitis suppurativa in two transgender men after initiation of testosterone therapy. Br J Dermatol. 2021;184(6):1192-4.
• Referans13. Manning JT, Scutt D, Wilson J, Lewis-Jones DI. The ratio of 2nd to 4th digit length: a predictor of sperm numbers and concentrations of testosterone, luteinizing hormone and oestrogen. Hum Reprod. 1998; 13(11): 3000-4.
• Referans14. Muller DC, Giles GG, Bassett J, Morris HA, Manning JT, Hopper JL et al. Second to fourth digit ratio (2D:4D) and concentrations of circulating sex hormones in adulthood. Reprod Biol Endocrinol. 2011 Apr 27;9:57. Referans15. Iljin A., Antoszewski B., Szewczyk T, Sitek A. The 2D:4D index is associated with the development of excess body weight in adults, but not with the rate of weight loss following bariatric surgery. Sci Rep. 2022;16; 12(1):8078.
• Referans16. Wu L, Yao R, Zhang Y, Wang Y, Li T, Chen M et al. The association between digit ratio (2D:4D) and overweight or obesity among Chinese children and adolescents: A cross-sectional study. Early Hum Dev. 2019;136:1