Manejo del paciente con hidradenitis supurativa

Martorell, A.; Caballero, Aránzazu; Lama, Y. González; Jiménez‐Gallo, David; Serrano, M. Lázaro; Miranda, Jesús García de Madariaga; Pascual, José C.; Salgado‐Boquete, Laura; Marín-Jiménez, Ignacio

doi:10.1016/s0001-7310(17)30007-8

Cited by 32 publications

(29 citation statements)

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“…It is important to note that disease severity and the number of involved areas in patients with HS directly correlates with depressed mood, poor quality of life and pain . In addition, in the absence of therapeutic intervention, the disease progresses and the lack of early treatment may increase the number of complications that may develop . Ultrasound staging would allow for early clinical intervention to prevent, as much as possible, the potential progression of the disease …”

Section: Discussionmentioning

confidence: 99%

“…In our study, there were statistically significant differences between anatomic regions. The number of fistulas was greater in both gluteal areas, and the number of fluid collections was higher in areas with lesions that will more likely require surgical interventions, such as the axillae and the groins . Moreover, since axillae are commonly uncovered in warmer seasons of the year, the presence of lesions in this area contributes to the stigmatization of patients with HS .…”

Section: Discussionmentioning

confidence: 99%

“…21,22 In addition, in the absence of therapeutic intervention, the disease progresses and the lack of early treatment may increase the number of complications that may develop. 23 Ultrasound staging would allow for early clinical intervention to prevent, as much as possible, the potential progression of the disease. 24 In our study, there were statistically significant differences between anatomic regions.…”

Section: Discussionmentioning

confidence: 99%

“…The number of fistulas was greater in both gluteal areas, and the number of fluid collections was higher in areas with lesions that will more likely require surgical interventions, such as the axillae and the groins. 23 Moreover, since axillae are commonly uncovered in warmer seasons of the year, the presence of lesions in this area contributes to the stigmatization of patients with HS. 25 This emphasizes the need for treatment adjustment in relationship to disease severity to prevent disease progression and to avoid more invasive interventions.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study

Martorell

Alfageme

Rull

et al. 2019

Acad Dermatol Venereol

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Background It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS). Objective To determine the usefulness of ultrasound as a diagnostic tool in HS compared with clinical examination and to assess the subsequent modification of disease management. Methods Cross‐sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared. Results Of 143 HS patients were included. Clinical examination scored 38, 70 and 35 patients as Hurley stage I, II and III, respectively; with ultrasound examination, 21, 80 and 42 patients were staged with Hurley stage I, II and III disease, respectively (P < 0.01). In patients with stage I classification as determined by clinical examination, 44.7% changed to a more severe stage. Clinical examination indicated that 44.1%, 54.5% and 1.4% of patients would maintain, increase or decrease treatment, respectively. For ultrasound examination, these percentages were 31.5%, 67.1% and 1.4% (P < 0.01). Concordance between clinical and ultrasound intra‐rater examination was 22.8% (P < 0.01); intra‐rater and inter‐rater (radiologist) ultrasound agreement was 94.9% and 81.7%, respectively (P < 0.01). Limitations The inability to detect lesions that measure ≤0.1 mm or with only epidermal location. Conclusion Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study

Martorell

Alfageme

Rull

et al. 2019

Acad Dermatol Venereol

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“…It is an important milestone that follows in the tracks of previous guidelines, and sets a new standard by its formal evidence‐based approach. This does not diminish the importance of previous guidelines and their contribution to the practical management of the disease as reflected by the overlap of recommendations between the various guidelines, but reflects the improved opportunity and theoretical framework for a stronger data‐driven analysis . Development and more data equal better guidelines.…”

mentioning

confidence: 99%

Evidence‐based hidradenitis suppurativa guidelines – and now all together please

Jemec

2019

Br J Dermatol

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Factors Affecting Treatment Selection Among Patients With Hidradenitis Suppurativa

Salame,

Sow,

Siira

et al. 2024

JAMA Dermatol

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ImportanceDespite the US Food and Drug Administration’s approval of adalimumab for the treatment of hidradenitis suppurativa (HS), prescription rates remain low, indicating a critical gap between evidence-based guidelines and clinical practice. Understanding the medical decision-making process that these patients use when considering biologic agents and other HS therapies may uncover opportunities for improved patient-physician communication and HS disease control.ObjectiveTo elucidate factors that affect the medical decision-making process for patients with HS, with an emphasis on biologic therapies.Design, Setting, and ParticipantsOpen-ended semistructured interviews were conducted with English-speaking adults with HS (aged ≥18 years) recruited from 2 dermatology clinics that are part of Emory University School of Medicine in Atlanta, Georgia. All participants had an average 7-day pain score of 1 or higher on a 0- to 10-point numeric rating scale. Surveys were conducted between November 2019 and March 2020, and data were analyzed from December 2021 to August 2022. Data collection continued until thematic saturation was reached at 21 interviews.ResultsA total of 21 participants (median [IQR] age, 38.5 [27.9-43.4] years; 16 females [76%]) were included in the analysis. Almost all participants (96%) had Hurley stage II or III disease, and 15 (71%) had a history of adalimumab use. Suffering threshold, perceptions of treatment risk, treatment fatigue, disease understanding, and sources of information (included dermatologists, the internet, advertisements, and friends and loved ones) were identified as factors affecting participants’ decisions to initiate new treatments for HS.Conclusions and RelevanceResults of this qualitative study suggest that mitigating misconceptions about treatment risk, identifying gaps in disease knowledge, and emphasizing early treatment to prevent scarring and disease progression may empower patients with HS to engage in treatment planning and to try new therapies.

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Manejo del paciente con hidradenitis supurativa

Cited by 32 publications

References 0 publications

Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study

Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study

Evidence‐based hidradenitis suppurativa guidelines – and now all together please

Factors Affecting Treatment Selection Among Patients With Hidradenitis Suppurativa

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