Abstract
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.
Highlights
Hidradenitis suppurativa (HS; known as acne inversa) is a chronically relapsing inflammatory disease with characteristic alterations in skinfolds [1]
To gain a deeper insight into these interactions, we first investigated the impact of HS on the quality of life (QoL) in a German patient cohort comprised of 500 HS patients (Figure 1)
The detected mean (± standard error of the mean (SEM)) Dermatology Life Quality Index (DLQI) score of all evaluated HS patients (n = 462) was 13.18 (± 0.37), indicating that HS has a profound effect on the lives of patients
Summary
Hidradenitis suppurativa (HS; known as acne inversa) is a chronically relapsing inflammatory disease with characteristic alterations in skinfolds [1]. HS is estimated to affect around 1% of the general population [2,3,4], with a common onset in the second and third decade of life [5]. The axillary, inguinal, and gluteal areas are most commonly affected. The inner thighs, perineal area, and sub- and infra-mammary skin may be involved [1]. HS leads to painful cutaneous lesions with malodorous discharge and causes irreversible destruction of normal skin structure. The clinical manifestation varies and includes recurring inflammatory nodules, abscesses, draining fistulas, and scars [1]. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with an adverse impact on patients’ quality of life (QoL)
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