Background
Hidradenitis suppurativa (
HS
) is a chronic, relapsing, inflammatory skin disease characterized by painful inflamed nodules, recurrent abscesses and fistulas located in apocrine gland–bearing body sites. The negative impact of
HS
on patient's quality of life (QoL) has been reported to be greater than other dermatologic conditions as psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for
HS
and generic dermatologic questionnaires are used.
Objective
The objective of this study was to demonstrate the validity, reliability and responsiveness of
HIDRA
disk, a new innovative tool designed for rapid assessment of
HS
burden and, at the same time, an intuitive graphic visualization of the measurement outcome.
Methods
A multicentre, longitudinal, observational study was conducted to validate the
HIDRA
disk compared with other validated questionnaires [Skindex‐16, Dermatology Life Quality Index (
DLQI
), Work Productivity and Activity Impairment–General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of
HS
severity, as measured by Hurley stage and
HS
Physician Global Assessment (
HS
‐
PGA
).
Results
A total of 140 patients (59% women; mean age 34.9 ± 11.0 years) were enrolled in 27 dermatologic centres.
HIDRA
disk showed a strong correlation with Skindex‐16 and
DLQI
, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and
HS
‐
PGA
. Very good internal consistency (Cronbach coefficient >0.80; intraclass correlation coefficient >0.6), with correlation between the 10 items, good test–retest reliability (Spearman correlation coefficient, 0.8331;
P
< 0.0001) and responsiveness to changes were demonstrated.
Conclusion
Our study shows that
HIDRA
disk, a short and innovative visual
HS
QoL instrument, has been psychometrically validated in Italian language and it may help improve the management of
HS
once implemented in routine clinical practice.
The efficacy of imiquimod in the treatment of external genital warts in HIV positive subjects was compared to a group of patients with normal immune function. Imiquimod 5% cream was applied by patients three times a week until resolution for a maximum of 16 weeks. Assessment for response and the occurrence of side effects was performed every four weeks. Thirty-one per cent of 75 HIV positive patients achieved a complete clearance, a partial response was obtained in 24% of subjects while in 45% we observed no clinical response. In the control group a total clearance was obtained in 62% of subjects, a partial response in 24% and no response in 14%. Recurrences occurred in 4/23 HIV patients and 2/31 immunocompetent patients within three months of follow-up. Side effects were minor to moderate. We conclude that imiquimod 5% cream has an acceptable efficacy and safety on HIV patients.
Psoriasis is an immune-mediated disease with a chronic relapsing course, and the particularly severe forms that are refractory to traditional therapies are often difficult to manage. Everolimus (Certican; Novartis, Basel, Switzerland) is a new rapamycin-derived macrolide that is used in the prophylaxis of rejection in heart and kidney transplant patients. The mechanism underlying its immunosuppressant and antiproliferative activity is different from, but complementary to, that of calcineurin inhibitors such as ciclosporin. We describe a woman with severe psoriasis treated with everolimus combined with subtherapeutic doses of ciclosporin.
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