Quality-of-Life Impairment among Patients with Hidradenitis Suppurativa: A Cross-Sectional Study of 1795 Patients

Krajewski, Piotr; Matusiak, Łukasz; Stebut, Esther von; Schultheis, Michael; Kirschner, Uwe; Nikolakis, Georgios; Szepietowski, Jacek C.

doi:10.3390/life11010034

Cited by 40 publications

(63 citation statements)

References 47 publications

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“…Jemec et al and Matusiak et al also determined that QoL impairment clearly correlates with the severity of skin alterations including the number of lesions (20,22), a fact that was confirmed by further studies (43)(44)(45) and was also observed in our study involving a large patient cohort. In this context, a very recently published study showed a positive correlation of QoL impairment with IHS4 (42). Moreover, we also found that anogenital localization of HS skin alterations has a substantial negative impact on QoL, an observation that was very recently published by Jørgensen et al (45).…”

Section: Discussionsupporting

confidence: 84%

“…Jemec et al noted that the highest proportion of physical disability resulted from the soreness and pain induced by HS (20). In fact, the presence of pain but not odor seems to be a crucial contributor to QoL impairment (39,40), and pain severity correlated significantly with DLQI (41,42). Moreover, embarrassment and diminished self-consciousness led to a considerable extent of QoL impairment in our patient cohort.…”

Section: Discussionmentioning

confidence: 57%

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Features Associated With Quality of Life Impairment in Hidradenitis Suppurativa Patients

et al. 2021

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Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with an adverse impact on patients' quality of life (QoL).Objectives: To quantify QoL impairment in patients in Germany suffering from HS and to identify the parameters associated with QoL impairment.Methods: A non-interventional, cross-sectional, mono-centric study with 500 HS patients. QoL data (measured using the Dermatology Life Quality Index; DLQI) and demographic, anamnestic, clinical, and blood parameters were collected. All patients were examined by dermatologists that documented the skin alterations. QoL data from 462 HS patients were available and evaluated.Results: The mean (± standard deviation) DLQI score of HS patients was 13.18 ± 7.99. Approximately 40% and 20% of HS patients declared very large and extremely large QoL impairment, respectively. The degree of QoL disturbance correlated with the severity of skin alterations, blood leucocyte count and, in particular, with anogenital localization and the presence of nodules and fistulas. Furthermore, QoL impairment was associated with specific comorbidities, such as adiposity and back pain, but not with HS family history. QoL impairment was not influenced by whether or not the patients had undergone resection surgery or antibiotic treatment but was more severe in HS patients that had undergone abscess lancing compared to patients without such treatment in the past.Limitations: It was a mono-centric study and most data were obtained from self-administered patient questionnaires. The association of QoL with type of treatment was analyzed for abscess lancing, resection surgery, and antibiotic treatment. Further therapeutic modalities recommended in the guidelines were not investigated.Conclusion: A profound impairment in QoL was present in patients with HS, and this was higher than that observed in other studied dermatoses. The degree of impairment correlated with the extent of cutaneous and some extra-cutaneous alterations. Surgical and conventional medicamentous therapies of HS were not associated with long-lasting reduction of QoL impairment. Our data support the implementation of patient-reported outcome measures for the assessment of therapy responses.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 57%

Features Associated With Quality of Life Impairment in Hidradenitis Suppurativa Patients

et al. 2021

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“…Other reasons for exclusion along with the flow chart are shown in Figure 1 . Finally, 17 studies, representing 4929 patients with HS, met the eligible criteria and were included and fully reviewed [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies evaluated the impact of pain in the QoL of HS patients, including 4216 participants with a mean age of 35.62 years ( Table 2 ) [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

Section: Resultsmentioning

confidence: 99%

The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

Montero‐Vílchez

Díaz-Calvillo

Rodríguez-Pozo

et al. 2021

IJERPH

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Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating inflammatory skin disease of the hair follicle that usually presents as painful, deep-seated inflamed lesions in the apocrine gland-bearing areas of the body. HS patients suffer from uncomfortable signs and symptoms, such as pain, pruritus, malodour and suppuration, which may impair patients’ quality of life (QoL). Although HS patients frequently experience these signs and symptoms, they are only occasionally assessed by clinicians and, unexpectedly, the scientific evidence available is limited and heterogeneous. The aim of this study is to summarize the evidence regarding the impact of HS signs and symptoms on QoL to serve as a basis for future research and help clinicians to consider them in the daily care of HS patients. A systematic review and meta-analysis were conducted following PRISMA Guidelines. The following search algorithm was used: (hidradenitis or “acne inversa”) and (pain or itch or odour or malodour or suppuration or oozing or drainage) and (“quality of life”). The literature search identified 836 references, 17 of them met the eligible criteria and were included for analysis, representing 4929 HS patients. Mean age of the participants was 36.28 years and there was a predominance of female sex among study participants. The BMI of the population was in the range of over-weight and about two out five patients were active smokers. Studies included patients with mild to moderate HS, with a mean disease duration of 13.69 years. The HS signs and symptoms assessed were pain, pruritus, malodour and suppuration. Overall, the higher intensity of a sign or symptom correlated with poorer general QoL or specific QoL dimensions including sexual distress, anxiety, depression and sleep. The most frequently employed tool to assess QoL was the Dermatology Life Quality Index (DLQI). DLQI was used in 52.9% of the studies (9/17) with a mean value of 10.70 (2.16 SD). The scores employed to assess signs and symptoms severity were subjective and varied between studies, being the numerical rating scale (NRS) for each of the most used symptoms. The mean NRS value for pain was 3.99 and the mean NRS for pruritus was 4.99. In conclusion, we have summarized, categorized and analyzed the scientific evidence regarding signs and symptoms in HS patients and their impairment in QoL. Their assessment should be thorough and included during routine evaluation of HS patients to motivate therapeutic modifications and increase patients’ health.

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“…Visual technology, such as standardised photography, ultrasound and thermography [ 9 , 10 , 11 , 12 ], together with digital technology for patient outcome measures, such as daily digital assessment of pain [ 13 ], have the potential to markedly improve the objective evaluation of HS severity assessment. On the other hand, HS continues to be the skin disease that causes the greatest impairment of quality of life (QoL) [ 14 ] and methods to measure this impairment, although developing, have not yet improved to the extent of other physical aspects of the disease [ 15 , 16 ]. It is likely that many studies on the QoL impact of HS will continue to be carried out: their rate of publication increased from 0–1 per year in the 1990s to 90 in 2019 (PubMed; Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in Hidradenitis Suppurativa: An Update

Chernyshov

Finlay

Tómas-Aragonés

et al. 2021

IJERPH

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Knowledge on hidradenitis suppurativa/acne inversa (HS) is rapidly increasing. HS has a profound impact on patients and their family life. Several factors, such as comorbidities, unemployment and HS severity, make this impact even more severe. The most widely used instrument to measure this impact is the dermatology-specific DLQI. We also identified six HS-specific health-related quality of life (HRQoL) instruments. Of them, HIDRAdisk, HSIA, HiSQOL and HSQoL-24 are better validated but there is still lack of experience of its use. Several treatment methods showed positive effect on patients’ HRQoL. Surgery remains a method with a substantial positive effect on HRQoL. Several studies confirming a positive effect of adalimumab on the HRQoL of patients with HS were published during the last three years. Data on the influence of several other biologics on HRQoL of HS patients are controversial or based on studies with a small number of patients.

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Quality-of-Life Impairment among Patients with Hidradenitis Suppurativa: A Cross-Sectional Study of 1795 Patients

Cited by 40 publications

References 47 publications

Features Associated With Quality of Life Impairment in Hidradenitis Suppurativa Patients

Features Associated With Quality of Life Impairment in Hidradenitis Suppurativa Patients

The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

Quality of Life in Hidradenitis Suppurativa: An Update

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