A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa

Abstract

Background: Hidradenitis suppurativa (HS) is one of the most distressing conditions observed in dermatology and has a substantial negative effect on the quality of life of affected persons. Objectives: The aim of this study was to evaluate different treatment strategies in patients with HS. Methods: In a retrospective cohort, all patients with HS (July 2015 to March 2017) were reviewed. Collected data consisted of patients’ demographics, clinical characteristics, psychosocial situation, and previous and current treatments. In addition, therapy response to the most recent prescribed treatments was assessed. Results: 102 patients (38 females, 64 males; median age 37.5 years) were included in this study. 68.4% of patients had BMI ≥25, and 76.5% of patients were current smokers. Hurley stages I, II, and III were detected in 13.5, 53.1, and 33.3% of patients, respectively. The most commonly administered treatments were surgery (67.6%), nonantibiotic topical therapies (72.5%), antibiotic topical therapies (55.9%), systemic antibiotics (88.2%), and biologics in 11.8% of the patients. 84.6% of the patients showed a response (27.5 and 47.1% partial and complete response, respectively) to the treatments. Conclusion: HS as a chronic, recurrent inflammatory skin disease is associated with smoking and obesity. Application of systemic antibiotics is the most frequent treatment strategy for this disease. However, surgical intervention seems to be the most effective treatment strategy.

Hidradenitis Suppurativa: Current Understanding of Pathogenic Mechanisms and Suggestion for Treatment Algorithm

“…Mechanical stress (45), metabolic syndrome (2,37,38), diet (46), smoking (2,38), and hormonal factors (47) have been reported in previous studies to contribute to the development or exacerbation of HS. While the epidemiological evidence for this is undisputed, at least for some factors such as smoking and obesity, the mechanism by which these factors contribute to HS pathogenesis remain far from clear.…”

“…As a result, clinicians typically should choose from different treatment modalities and often have to combine them to achieve disease control. The choice of treatment depends on the distribution and overall severity of disease, the anatomic location and inflammatory activity of the lesions, the patient's comorbidities, as well as treatment cost and availability (2,5,9,38). In order to assess the severity and extent of hidradenitis suppurativa various scoring systems are in common use: hurley stages, sartorius hidradenitis suppurativa score, hidradenitis suppurativa physician global assessment (HS-PGA) and hidradenitis suppurativa clinical response (HiSCR) (57)(58)(59).…”

“…Hidradenitis suppurativa (HS) is a chronic skin disorder, which profoundly decrease quality of life because of emotional, physical and psychologic consequences (1)(2)(3)(4)(5)(6). This recurrent inflammatory skin condition with an estimated prevalence of 1-4% is more frequent in women (2,5,7,8).…”

“…Hidradenitis suppurativa (HS) is a chronic skin disorder, which profoundly decrease quality of life because of emotional, physical and psychologic consequences (1)(2)(3)(4)(5)(6). This recurrent inflammatory skin condition with an estimated prevalence of 1-4% is more frequent in women (2,5,7,8). Most frequently, the age of onset is between 20 and 40 years of life, although postmenopausal women and prepubertal children with new-onset HS have been reported (2,5,9,10).…”

“…This recurrent inflammatory skin condition with an estimated prevalence of 1-4% is more frequent in women (2,5,7,8). Most frequently, the age of onset is between 20 and 40 years of life, although postmenopausal women and prepubertal children with new-onset HS have been reported (2,5,9,10). The clinical manifestations range from inflamed nodules and abscesses to draining sinus tracts and formation of scars (5,11,12).…”