The Broad-Spectrum Impact of Hidradenitis Suppurativa on Quality of Life: A Comparison with Psoriasis

Sampogna, Francesca; Fania, Luca; Mazzanti, Cinzia; Caggiati, Alessio; Pallotta, Sabatino; Panebianco, Annarita; Mastroeni, Simona; Didona, Biagio; Pintori, G; Abeni, Damiano

doi:10.1159/000496604

Cited by 19 publications

(23 citation statements)

References 32 publications

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“…Other reasons for exclusion along with the flow chart are shown in Figure 1 . Finally, 17 studies, representing 4929 patients with HS, met the eligible criteria and were included and fully reviewed [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies evaluated the impact of pain in the QoL of HS patients, including 4216 participants with a mean age of 35.62 years ( Table 2 ) [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…The mean NRS value was 3.99 (SD 0.95) after conducting a random effect meta-analysis weighted by the study sample size ( Figure 3 ). VAS was the second most employed tool for pain but was scored in different ways [ 26 , 27 , 29 , 32 , 35 ]. PainDETECT [ 27 ], boil-associated pain score [ 28 ] and self-reported number of painful lesions [ 36 ] were other ways of pain severity assessment.…”

Section: Resultsmentioning

confidence: 99%

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The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

Montero‐Vílchez

Díaz-Calvillo

Rodríguez-Pozo

et al. 2021

IJERPH

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Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating inflammatory skin disease of the hair follicle that usually presents as painful, deep-seated inflamed lesions in the apocrine gland-bearing areas of the body. HS patients suffer from uncomfortable signs and symptoms, such as pain, pruritus, malodour and suppuration, which may impair patients’ quality of life (QoL). Although HS patients frequently experience these signs and symptoms, they are only occasionally assessed by clinicians and, unexpectedly, the scientific evidence available is limited and heterogeneous. The aim of this study is to summarize the evidence regarding the impact of HS signs and symptoms on QoL to serve as a basis for future research and help clinicians to consider them in the daily care of HS patients. A systematic review and meta-analysis were conducted following PRISMA Guidelines. The following search algorithm was used: (hidradenitis or “acne inversa”) and (pain or itch or odour or malodour or suppuration or oozing or drainage) and (“quality of life”). The literature search identified 836 references, 17 of them met the eligible criteria and were included for analysis, representing 4929 HS patients. Mean age of the participants was 36.28 years and there was a predominance of female sex among study participants. The BMI of the population was in the range of over-weight and about two out five patients were active smokers. Studies included patients with mild to moderate HS, with a mean disease duration of 13.69 years. The HS signs and symptoms assessed were pain, pruritus, malodour and suppuration. Overall, the higher intensity of a sign or symptom correlated with poorer general QoL or specific QoL dimensions including sexual distress, anxiety, depression and sleep. The most frequently employed tool to assess QoL was the Dermatology Life Quality Index (DLQI). DLQI was used in 52.9% of the studies (9/17) with a mean value of 10.70 (2.16 SD). The scores employed to assess signs and symptoms severity were subjective and varied between studies, being the numerical rating scale (NRS) for each of the most used symptoms. The mean NRS value for pain was 3.99 and the mean NRS for pruritus was 4.99. In conclusion, we have summarized, categorized and analyzed the scientific evidence regarding signs and symptoms in HS patients and their impairment in QoL. Their assessment should be thorough and included during routine evaluation of HS patients to motivate therapeutic modifications and increase patients’ health.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

Montero‐Vílchez

Díaz-Calvillo

Rodríguez-Pozo

et al. 2021

IJERPH

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“…In HS patients with depression, disease severity as measured by the IHS4, and QoL measured by Skindex-17 and DLQI and SF-36 were significantly worse compared to HS patients with no depression [ 79 ]. When comparing the QoL impact of HS to that of psoriasis, the Skindex-17 scores of patients with HS were higher than those of psoriasis patients on 16 of the 17 Skindex items [ 80 ]. In the adjusted analysis, patients with HS who had previously not used opioids had 1.53 times the odds of using long-term opioids compared with controls ( p < 0.001) [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

Quality of Life in Hidradenitis Suppurativa: An Update

Chernyshov

Finlay

Tómas-Aragonés

et al. 2021

IJERPH

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Knowledge on hidradenitis suppurativa/acne inversa (HS) is rapidly increasing. HS has a profound impact on patients and their family life. Several factors, such as comorbidities, unemployment and HS severity, make this impact even more severe. The most widely used instrument to measure this impact is the dermatology-specific DLQI. We also identified six HS-specific health-related quality of life (HRQoL) instruments. Of them, HIDRAdisk, HSIA, HiSQOL and HSQoL-24 are better validated but there is still lack of experience of its use. Several treatment methods showed positive effect on patients’ HRQoL. Surgery remains a method with a substantial positive effect on HRQoL. Several studies confirming a positive effect of adalimumab on the HRQoL of patients with HS were published during the last three years. Data on the influence of several other biologics on HRQoL of HS patients are controversial or based on studies with a small number of patients.

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“…However, patients with HS represent a peculiar population, characterized by high levels of physical and emotional suffering. In a recent study, Sampogna et al [35] have shown an unprecedented impact of HS on HRQoL compared to other dermatological conditions, reporting also higher scores in women than in men. Due to the higher psychosocial impact of HS on women, our hypothesis is that these patients could use alexithymia as a coping strategy and defense mechanism against physical (e.g., chronic pain, bleeding) and psychological (e.g., embarrassment, stigmatization) symptoms related to HS.…”

Section: Discussionmentioning

confidence: 99%

Alexithymia, Psychological Distress, and Social Impairment in Patients with Hidradenitis Suppurativa

et al. 2019

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Background: Hidradenitis suppurativa (HS) is a rare, chronic, inflammatory skin disease characterized by deep-seated nodules, abscesses, and draining fistulas. HS has a substantial adverse impact on patients’ lives. Only a few studies investigated the relationship between health-related quality of life, psychological distress, and emotional dysregulation in patients with HS. Alexithymia, namely the difficulty in describing or recognizing emotions, has been associated with various psychological disorders, such as anxiety, depression, and psychological distress. Objective: The aim of this study was to examine the prevalence of alexithymia in patients with HS and its association with demographic and clinical variables, quality of life indices, and psychological distress. Methods: Ninety outpatients with HS completed the 20-item Toronto Alexithymia Scale, the 12-item General Health Questionnaire (GHQ-12), the Dermatology Life Quality Index, the Skindex-17, and the 36-Item Short-Form Health Survey. Information on sociodemographic and clinical variables was retrieved from clinical records. Results: Alexithymia or borderline alexithymia was observed in 44.4% of patients with HS, with a higher prevalence of the alexithymic trait in women than in men (51.7 vs. 31.2%). We did not find any association between alexithymia and clinical variables. Of the entire sample analyzed, 46.1% reported high psychological distress; among them, 78% reported alexithymia or borderline alexithymia compared to 16.7% among GHQ noncases. Furthermore, HS patients with alexithymia or borderline alexithymia showed significantly higher scores on the Skindex-17 psychosocial scale and the Dermatology Life Quality Index, and a lower score on the mental component of the 36-item Short-Form Health Survey, than nonalexithymic patients. Conclusions: Dermatologists should consider alexithymia in the diagnosis and treatment of HS patients, given its important role in psychological and psychosocial distress.

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The Broad-Spectrum Impact of Hidradenitis Suppurativa on Quality of Life: A Comparison with Psoriasis

Cited by 19 publications

References 32 publications

The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis

Quality of Life in Hidradenitis Suppurativa: An Update

Alexithymia, Psychological Distress, and Social Impairment in Patients with Hidradenitis Suppurativa

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