Hidradenitis suppurativa: a common and burdensome, yet under-recognised, inflammatory skin disease

Abstract

Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin condition that typically occurs after puberty. The primary clinical presentation is painful inflamed nodules or boils in the apocrine gland-bearing regions (armpits, genital area, groin, breasts and buttocks/anus) that progress to abscesses, sinus tracts and scarring. Severity is typically described according to three Hurley categories, with most patients having mild or moderate disease. Estimated prevalence is 1–4% worldwide and HS is three times more common in women than men. Patients’ disease burden includes intense pain, work disability and overall poor quality of life. Although the clinical signs of the disease can often be hidden by clothing, active HS is associated with a malodorous discharge that contributes to the disabling social stigma. Risk factors include smoking and obesity. Comorbidities include inflammatory bowel disease and spondyloarthropathies. The presentation of the disease is distinct, yet HS is not well-recognised except in dermatology clinics.

Hidradenitis Suppurativa in General Practice: A Pilot Study

“…HS is a chronic inflammatory debilitating skin disease and is one of the most distressing conditions observed in dermatology [14][15][16]. Nevertheless, patients experience a significant delay in diagnosis.…”

Adalimumab for Treating Moderate-to-Severe Hidradenitis Suppurativa: An Evidence Review Group Perspective of a NICE Single Technology Appraisal

“…HS affects young adults, with disease onset typically between the second and fourth decades of life [6,7]. Within the adult European population, a prevalence of 1% has been reported [8], although true prevalence is likely to be higher due to problems of under-recognition [9,10]. Whilst there are no published data on HS prevalence in the UK, it has been suggested that this might be in the region of 1 in 600 [6].…”

“…HS has a higher prevalence in women than men and around one-third of patients have the disease in first-degree relatives. The other important known risk factors for HS are obesity and cigarette smoking [8][9][10]. Studies have suggested that active disease can substantially impair patients' health-related quality of life (HRQoL), with an impact which exceeds that of other skin diseases such as alopecia, acne, mild to moderate psoriasis, vascular anomalies of the face and atopic dermatitis.…”

“…Studies have suggested that active disease can substantially impair patients' health-related quality of life (HRQoL), with an impact which exceeds that of other skin diseases such as alopecia, acne, mild to moderate psoriasis, vascular anomalies of the face and atopic dermatitis. Given the debilitating impact of HS, measures of pain and HRQoL, especially the Dermatology Quality of Life Index (DLQI), are recognised as being useful for clinical management of the disease [8,10].…”

Hidradenitis Suppurativa: Modern Concepts of Pathogenesis and Therapy; Successful Experience of Adalimumab Therapy

“…Такие проявления болезни, как выраженная боль, ограничение подвижности, сви-щевые ходы с отделяемым, имеющим неприятный запах, приводят к снижению самооценки, работоспособности, развитию депрессии и, как следствие, социальной изоля-ции больных [21][22][23].…”