Patient Satisfaction and Quality of Life Following Surgery for Hidradenitis Suppurativa

Kohorst, John J.; Baum, Christian L.; Otley, Clark C.; Roenigk, Randall K.; Pembérton, John H.; Dozois, Eric J.; Tran, Nho V.; Davis, Mark D.P.

doi:10.1097/dss.0000000000000942

Cited by 32 publications

(37 citation statements)

References 17 publications

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“…This effect may be a result of expectation bias, wherein physicians identify patients who are at a high risk of recurrence or more severe disease and pre‐emptively prescribe medications. Of note, disease recurrence is not a failure of surgery—it is a feature that characterises the natural course of the disease and does not affect patient satisfaction . Wide excision is the only potentially curative therapy for HS and its impact is far‐reaching, with patients reporting improved functional status, increased employment, and improved quality of life .…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Ngaage

et al. 2019

International Wound Journal

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Wide local excision is the gold standard and only potential curative therapy for recalcitrant hidradenitis suppurativa. However, high recurrence rates persist even post-surgery with little known on the influencing factors for remission. We evaluated the effect of patient, disease, and operative factors on local cure rate of moderate to severe hidradenitis following wide local excision. We performed a retrospective chart review for all patients who had undergone surgical excision of hidradenitis at a university hospital from 2012 to 2018. We identified 79 patients with a total of 220 operative sites. The majority were obese (mean body mass index [BMI] 32.5), female (71%), African-American (84%), and had a mean age of 31 years. A quarter of operative sites experienced a recurrence (n = 56). Patients who achieved remission had a significantly lower number of affected regions than those who experienced a recurrence (2.3 vs 3.6, P = .0023). Additionally, recurrence rate differed significantly between body locations (P = .0440). Smoking, BMI, Hurley grade, closure method, and excision size did not influence local cure rate. Surgical excision remains a worthy management option for hidradenitis patients with three quarters achieving remission after a single operation. Number of affected regions and location of hidradenitis may play a factor in recurrence.

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Section: Discussionmentioning

confidence: 99%

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Ngaage

et al. 2019

International Wound Journal

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“…101 No controlled, prospective studies exist, but deroofing appears to be effective for acute and chronic lesions, with utility in a variety of outpatient settings. 7,84,101,102,[190][191][192] In contrast to deroofing, incision and drainage has been associated with recurrence rates approaching 100%, although it provides acute relief when other methods are not feasible. 84,89,107,192,193 In general, deroofing small lesions with a punch tool or by other Table III.…”

Section: Surgical Modalities In Hsmentioning

confidence: 99%

“…There was a 24.4% overall recurrence rate, with younger age and operation at multiple sites associated with increased risk. 84,192 Another series of 31 patients treated with drainage, limited surgery, or radical excision reported 100%, 42.8%, and 27% recurrence rates, respectively, with a mean follow-up of 72 months. 193 Carbon dioxide (CO 2 ) laser excision and marsupialization (laser vaporization of the wound base and edges to create a pocket-like defect with smooth, rounded edges) with secondary intention healing, in particular, seem to be associated with low recurrence rates, though they can have prolonged healing times.…”

Section: Surgical Modalities In Hsmentioning

confidence: 99%

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North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations

Alikhan

Sayed

Alavi

et al. 2019

Journal of the American Academy of Dermatology

268

382

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Hidradenitis suppurativa is a chronic inflammatory disorder affecting hair follicles, with profoundly negative impact on patient quality of life. Evidence informing ideal evaluation and management of patients with hidradenitis suppurativa is still sparse in many areas, but it has grown substantially in the last decade. Part I of this evidence-based guideline is presented to support health care practitioners as they select optimal management strategies, including diagnostic testing, comorbidity screening, and both complementary and procedural treatment options. Recommendations and evidence grading based on the evidence available at the time of the review are provided.

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“…We identified seven clinical trials of infliximab, 23-29 six of adalimumab, [30][31][32][33][34][35] three of etanercept 22,36,37 and two of ustekinumab. 38,39 There were five publications on surgical treatment, [40][41][42][43][44] one study on combination of surgical treatment with photodynamic therapy 45 and two other studies on photodynamic therapy. 46,47 There were three studies on antibiotics, [48][49][50] single studies on metformin, 51 PUVA, 52 hyperbaric oxygen therapy, 53 alitretinoin, 54 acitretin, 55 ankinra, 56 apremilast, 57 oral zinc gluconate combined with topical triclosan 58 and verapamil.…”

Section: Clinical Trials In Hsmentioning

confidence: 99%

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Chernyshov

Zouboulis

Tómas-Aragonés

et al. 2019

Acad Dermatol Venereol

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This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient‐Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS‐specific health‐related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high‐quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double‐blind randomized placebo‐controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well‐designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long‐term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS‐specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology‐specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS‐specific, dermatology‐specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient‐Oriented Outcomes.

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Patient Satisfaction and Quality of Life Following Surgery for Hidradenitis Suppurativa

Abstract: Hidradenitis suppurativa surgical management was well regarded by patients and should be considered by future patients to limit the morbidity of HS.

Cited by 32 publications

References 17 publications

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

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