26528 Hidradenitis suppurativa disease severity associated with objective markers of inflammation and patient-reported pain

Abstract

Acute phase reactants, namely erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6), play a role in the exaggerated inflammation central to hidradenitis suppurativa (HS). Pain is also a hallmark of HS, but Numeric Rating Scale (NRS) patient-reported pain has not been studied as a marker of disease severity. We examined the relationship between these serum inflammatory markers, pain, and HS severity. Retrospective chart review was conducted of 333 patients seen at the Montefiore HS Center. Participants were mostly female (73.9%) with mean age of 36.1 ± 12.6. Disease activity was classified according to the HS-Physician Global Assessment (HS-PGA) scale. Serum samples were analyzed for ESR, CRP, and IL-6. Participants with severe disease (HS-PGA 3-5, n = 150) had higher inflammatory markers than those with mild disease (HS-PGA 0-2, n = 183) (ESR [63.26 ± 37.23 vs 32.55 ± 24.22, P < .0001], CRP [3.33 ± 5.55 vs 0.91 ± 1.27, P < .0001], and IL-6 [19.09 ± 25.92 vs 7.63 ± 22.29, P < .0001]). Patient-reported pain was higher in those with severe disease (3.76 ± 3.33 vs 1.24 ± 2.33). When adjusting for age, sex, and BMI, more severe disease was associated with increased ESR (OR 1.04, 95% CI 1.02-1.05), CRP (OR 1.58, 95% CI 1.29-1.93) and IL-6 (OR 1.02, 95% CI 1.01-1.04) as well as increased pain (OR 1.35, 95% CI 1.22-1.50). In one of the largest samples examining inflammatory markers in HS, we found ESR, CRP, and IL-6 were reliable markers of disease severity. Additionally, patient-reported pain may be useful in assessment of disease status. Our preliminary findings further characterize the utilization of these measures of disease severity in HS management.