The clinical, biochemical, and ultrasonographic characteristics of patients with hidradenitis suppurativa in Northern Peninsular Malaysia: a multicenter study

Loo, Chai Har; Tan, Wooi Chiang; Tang, Jyh Jong; Khor, Yek Huan; Manikam, Manimala T.; Low, Dyoi-E; Chan, Kam H.; Chan, Kok Hoe; Teoh, Yuen Mey; Sohot, Nurul Q. A.; Tang, Min; Chan, Lee Chin

doi:10.1111/ijd.14210

Cited by 46 publications

(55 citation statements)

References 35 publications

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“…Genetic susceptibility is also likely a contributing factor to the association between HS and metabolic syndrome. Interestingly in our systematic review, the results of Loo et al . in Malaysian participants showed no significant association between HS and metabolic syndrome.…”

Section: Discussioncontrasting

confidence: 59%

“…Loo et al . performed a retrospective cross‐sectional case‐control study comparing 62 HS cases with 52 age and ethnic matched controls, from a Malaysian population.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 151 references were identified from electronic database search using the search strategy in Table S1. After application of inclusion and exclusion criteria, six case-control studies [16][17][18][19][20][21] remained for systematic review and meta-analysis ( Fig. S1).…”

Section: Search Strategy and Critical Appraisalmentioning

confidence: 99%

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Hidradenitis suppurativa and metabolic syndrome – systematic review and adjusted meta‐analysis

2019

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Background Hidradenitis suppurativa (HS) is a debilitating and distressing chronic systemic inflammatory skin disease. There have been several prior observational studies which reported a possibility link between HS and metabolic syndrome, however the current evidence is not definitive. It is unclear in HS whether this possible relationship is independent or driven by underlying risk factors and comorbidities. Objective To determine whether HS is independently associated with metabolic syndrome via adjusted meta‐analysis of case‐control studies. Methods A systematic review and meta‐analysis was performed according to PRISMA guidelines. Electronic searches were performed using six electronic databases (Ovid Medline, PubMed, CCTR, CDSR, ACP Journal Club, and DARE) from their inception until September 2018. Data were extracted and analyzed according to predefined clinical endpoints. Results We identified six case‐control studies included for meta‐analysis. Based on unadjusted analysis, we found a significant association between adult cases of HS and metabolic syndrome (OR 1.95, 95% CI 1.31–2.89, P = 0.001). Adjusted meta‐analysis, after adjustment for age, sex, other cardiovascular risk factors, and comorbidities, found a significant association (OR 2.19, 95% CI 1.70–2.81, I2 = 32%, P < 0.00001). Limitations Studies reviewed were observational by design which are susceptible to bias, and there was lack of randomization. The quality of the current systematic review is also limited by the quality of available evidence which was predominantly observational in nature. Conclusions This pooled analysis of existing case‐control studies supports an association between HS and metabolic syndrome. Clinicians treating patients with HS should be aware of this potential association.

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Section: Discussioncontrasting

confidence: 59%

“…Loo et al . performed a retrospective cross‐sectional case‐control study comparing 62 HS cases with 52 age and ethnic matched controls, from a Malaysian population.…”

Section: Resultsmentioning

confidence: 99%

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Hidradenitis suppurativa and metabolic syndrome – systematic review and adjusted meta‐analysis

2019

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“…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%

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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“…Different studies have suggested that US may help in HS management by enhancing the visualization and the extension of different cutaneous lesions, so to support an early diagnosis and a more precise assessment of disease severity …”

Section: Ultrasound In Hidradenitis Suppurativamentioning

confidence: 99%

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

Lacarrubba

Dini

Napolitano

et al. 2019

Acad Dermatol Venereol

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Background Ultrasound (US) is a real‐time non‐invasive technique that has been demonstrated to support an early diagnosis and a more precise assessment of hidradenitis suppurativa (HS). Objectives To compare the clinical and US evaluation of a series of HS patients. Methods 434 HS patients (259 F, 175 M; mean age 33.82 ±13.31 years) observed across 19 Italian dermatology centres [members of the Italian Ultrasound Working Group (IUWG)] were enrolled in a retrospective study. Clinical staging was obtained by the Hidradenitis Suppurativa Physician's Global Assessment score (HS‐PGA), while the ultrasonographic staging was determined by the US HS‐PGA, based on the same scores as clinical HS‐PGA but performed with the aid of US. Results At the end of the study, the mean clinical and US HS‐PGA scores were 2.70 and 2.92, respectively. Direct comparison of clinical and ultrasonographic assessment revealed that a higher proportion of patients was classified as having moderate and very severe disease by US. In particular, 117 patients (26.96%) had a worse classification by US HS‐PGA compared to clinical assessment. Conclusion Our findings confirm that the use of clinical grading only to assess HS severity may underestimate the real disease severity. US examination can be considered an essential non‐invasive imaging tool available to dermatologists for a more accurate diagnosis, staging, treatment planning and monitoring of HS and should be included in the pathway to an optimal standard of care of HS.

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The clinical, biochemical, and ultrasonographic characteristics of patients with hidradenitis suppurativa in Northern Peninsular Malaysia: a multicenter study

Cited by 46 publications

References 35 publications

Hidradenitis suppurativa and metabolic syndrome – systematic review and adjusted meta‐analysis

Hidradenitis suppurativa and metabolic syndrome – systematic review and adjusted meta‐analysis

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

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

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