Authors: Sartorius, K.; Emtestam, L.; Jemec, G.B.E.; Lapins, J.

Source: British Journal of Dermatology, Volume 161, Number 4, October 2009 , pp. 831-839(9)

Publisher: Wiley-Blackwell

Abstract:

Summary Background 

Hidradenitis suppurativa (HS) is a long-standing disease with abscess and often fistula formation, predominantly in the axillae and groins. The disease is difficult to treat and has a severe impact on quality of life. A clinically relevant system for scoring disease severity is lacking in HS. Objectives 

To evaluate the modified Hidradenitis Suppurativa Score (HSS) and to study the impact of body mass index (BMI) and smoking habits on disease severity. Methods 

Two hundred and fifty-one consecutive patients with HS referred to a clinic with special interest in the disease were included, of whom 115 were scored. Points were given for regions involved, types of lesion (nodules, fistulas), total area involved and whether lesions were separated by normal skin. Background characteristics included BMI and smoking habits. Two hundred and forty-six patients completed the Dermatology Life Quality Index (DLQI). Results 

The median (interquartile range, IQR) HSS for all patients was 38 (18-66): women 38 (18-71) and men 37 (19-51). Median (IQR) HSS for smokers was 41 (22-75·5), former smokers 27 (16-53) and nonsmokers 22 (10-57). Median (IQR) HSS for patients with BMI < 25 kg m⁻² was 32 (12-54), BMI 25-30 kg m⁻² 44 (22-56) and BMI ≥ 30 kg m⁻² 50 (18-86). Mean ± SD DLQI for the whole group of patients was 10·3 ± 7·5, median 9, and showed no significant differences between the groups studied. There was a significant positive correlation of fair degree between HSS and DLQI. There were significant differences in HSS between nonsmokers and smokers as well as between women of normal weight compared with obese women. Conclusions 

The modified HSS is simple and practical and it extracts important clinical information. A connection between disease severity and BMI as well as smoking habits in patients with HS is presented. The results suggest that the HSS may be a relevant outcome measure in future therapeutic trials in HS.

Keywords: body mass index; Dermatology Life Quality Index; hidradenitis suppurativa; scoring; severity; smoking

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2133.2009.09198.x

Affiliations: 1: Department of Dermatology, Health Sciences Faculty, University of Copenhagen, Roskilde Hospital, Roskilde, Denmark

Publication date: 2009-10-01

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