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Studies with larger sample size investigating the mycobiome in preclinical HS skin as well as the gut mycobiome are warranted in HS. Although the participating patients had similar therapeutic experiences previously, we were unable to document long-term systematic changes of the skin mycobiome when sampling hair follicles. We thus investigated the skin mycobiome in HS patients and healthy controls using high throughput amplicon sequencing of the highly conserved eukaryotic 18S ribosomal RNA gene. [Extracted from the article]

Background: Atopic dermatitis (AD) is a prevalent chronically relapsing inflammatory skin disease of childhood. However, little is known about self‐reported trigger factors, impact on daily life and factors associated with AD severity. Methods: A nationwide questionnaire study of children in Denmark with hospital‐diagnosed AD in the time period 2014–2018. The web‐based questionnaire was completed by the legal parents. AD severity was assessed using Patient‐Oriented Eczema Measure (POEM) tool. Results: Of 3438 invited parents, 1343 (39%) completed the questionnaire. Factors associated with severe AD were onset during the first 6 months of life, onset of AD on multiple body regions, a history of hay fever, female sex and low maternal educational level. Staying home from daycare or school due to AD, concentration problems and sleep disturbances in the child were more frequently reported by parents to children with severe AD. Overall, 90% reported at least one AD trigger factor, and all were more frequently reported in children with severe AD. The three most commonly reported trigger factors were cold weather (51.9%), chlorinated water (35.7%) and warm weather (30.2%). Conclusions: We identified factors associated with severe AD in childhood, the impact on daily life, as well as the most common self‐reported triggers of AD. These findings may be valuable in clinical practice to inform about prognosis and educate families about trigger avoidance. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that severely impairs patients' quality of life. It is characterized by recurrent painful nodules, abscesses and draining sinus tracts in primarily intertriginous areas. We aimed to review the most up‐to‐date information regarding the epidemiology, clinical presentation, diagnostic studies, pathogenesis, comorbidities and quality of life of patients with hidradenitis suppurativa. We performed a systematic search of Medline, Embase database (from inception to September 2019) and review of bibliographies without restrictions on year or language. HS has an estimated global prevalence of 0.00033–4.1% (but most likely 0.7–1.2% in the European‐US population). Patients still experience a significant diagnostic delay, up to several years. In the absence of pathognomonic tests, the diagnosis of HS is made from clinical observation and the disease narrative. Phenotypic variation renders diagnosis and severity assessment difficult. Ultrasound imaging is an emerging assessment tool for deep‐seated lesions. The Hurley Staging System is still widely used in severity rating. Follicular hyperkeratosis and dilatation, follicular rupture and chronic inflammation with architectural tissue changes have been implicated in the pathogenesis of HS. HS has been associated with metabolic syndrome and other risk factors for cardiovascular disease, diabetes mellitus type II, polycystic ovarian syndrome, depression, suicide and substance use disorders. It has been linked to other immune‐mediated diseases such as inflammatory bowel disease and spondyloarthropathy. Pain, pruritus, malodour, low self‐esteem, sleep and sexual dysfunctions, and poor mental health are chronic symptoms or consequences of uncontrolled disease. HS is an under‐diagnosed and under‐treated disease with a profound negative impact on patients' quality of life. In the light of its associated comorbidities, an interdisciplinary management approach may be needed to ensure the best outcomes. [ABSTRACT FROM AUTHOR]

Summary: Background: Pain is a prominent symptom of hidradenitis suppurativa (HS) and has been defined as a domain in the Core Outcome Set for the disease. Quality and intensity of pain is influenced by depression and anxiety, both of which are associated with HS. Objectives: To describe HS‐related pain quantitatively and qualitatively; and to investigate how disease severity, depression and anxiety correlate with self‐reported pain quality. Methods: Pain perception was investigated using the McGill Pain Questionnaire. Symptoms of depression and anxiety were examined using the Hospital Anxiety and Depression Scale. Statistical analyses investigated differences in number of words chosen (NWC) and pain‐rating index rank [PRI(R)] in patients with severe disease and in patients with depression/anxiety. Results: A total of 138 patients with HS were recruited in an outpatient clinic (October 2017–March 2018). Patients presented a median NWC of 11·5 and a PRI(R) of 59·0%. Most common descriptors were 'shooting' (83%), 'itchy' (79%) and 'blinding' (75%). Patients with depression or anxiety presented significantly higher PRI(R)s [depressed 65% vs. non‐depressed 57% (P = 0·015); anxious 65% vs. nonanxious 57% (P = 0·004)]. Patients with involvement of three or more HS regions vs. those with fewer than three involved regions exhibited a significantly higher NWC (13 vs. 8; P = 0·048). Conclusions: HS‐related pain includes nociceptive and neuropathic pain, and perception appears to be influenced by disease severity, anxiety and depression. A multimodal pain management strategy may be the most appropriate; however, more detailed studies are necessary to define recommendations on pain management. What's already known about this topic? Pain is a core outcome domain hidradenitis suppurativa. Few studies have addressed this significant clinical problem. What does this study add? This study suggests that HS pain comprises both nociceptive and neuropathic pain. Pain appears associated to depression, anxiety and severity of the disease. Plain language summary available online Linked Comment: Alhusayen. Br J Dermatol 2020; 182:17–18. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa/ I acne inversa i (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly on the axillary, inguinal and anogenital regions.1 European studies estimate HS prevalence in various populations at 0.03-1%.2,3 The disease has an important negative impact on the quality of life, and its treatment is challenging.1,4 In 2015, we started a European Registry for HS (ERHS) under the auspices of the European HS foundation (EHSF). 6 ERHS remains compatible with the Scandinavian registry for HS (HISREG) but is significantly more detailed.7 For future collaborative projects, it is of the outmost importance to have shared variables in order to be able to merge the different databases of the different participating centres. In conclusion, ERHS is a flexible project with potential applications inside or outside Europe and represents a promising tool for future, better understanding of HS. [Extracted from the article]

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. Recent next‐generation sequencing (NGS) studies suggest genera such as Prevotella spp., Peptoniphilus spp. and Porphyromonas spp. are associated with chronic and early HS lesions. However, a systematic investigation of the bacterial microbiome in HS tunnels remains unexplored using NGS. Objective: We aimed to investigate the bacterial composition of the luminal white gelatinous material found in HS tunnels using NGS. Methods: An exploratory study of patients with diagnosis of HS (n = 32) with tunnels. The tunnels were present either in the groin (n = 17) or in the axilla (n = 15). During deroofing of the tunnels, a sterile E‐swab was taken of the luminal gelatinous material. The samples were investigated using NGS targeting 16S ribosomal RNA. Results: The skin microbiome was characterized in 32 HS patients. Overall, five microbiome types were identified: Porphyromonas spp. (type I), Corynebacterium spp., (type II), Staphylococcus spp. (type III), Prevotella spp. (type IV) and Acinetobacter spp (type V). Porphyromonas spp. (type I) and Prevotella spp. (IV) were the most frequent genera found the tunnels. Conclusion: This study points to a potential association between the presence of certain anaerobic bacteria (Porphyromonas spp., Prevotella spp.) and HS tunnels. It may be speculated that these two genera are associated with the pathogenesis in HS either as drivers or as biomarkers. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient Oriented Outcomes, Melanoma and Non‐Melanoma Skin Cancer (NMSC) present a review of the literature and position statement on health‐related (HR) QoL assessment in skin cancer patients. A literature search was carried out to identify publications since 1980 that included information about the impact of SC on QoL. Generic, dermatology‐specific, cancer‐specific, SC‐specific, facial SC‐specific, NMSC‐specific, basal cell carcinoma‐specific and melanoma‐specific QoL questionnaires have been used to assess HRQoL in SC patients. HRQoL was assessed in the context of creation and validation of the HRQoL instruments, clinical trials, comparison of QoL in SC and other cancers, other diseases or controls, HRQoL assessment after treatment, comorbidities, behaviour modification, predictors of QoL and survival, supportive care needs, coping strategies and fear of cancer recurrence. The most widely used instruments for HRQoL assessment in SC patients are the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ‐C30), the Functional Assessment of Cancer Therapy‐Melanoma (FACT‐M), Skin Cancer Index (SCI), Short Form 36 Item Health Survey (SF‐36) and the Dermatology Life Quality Index (DLQI). The TFs recommend the use of the cancer‐specific EORTC QLQ‐C30, especially in late stages of disease, and the melanoma‐specific FACT‐M and SC‐specific SCI questionnaires. These instruments have been well validated and used in several studies. Other HRQoL instruments, also with good basic validation, are not currently recommended because the experience of their use is too limited. Dermatology‐specific HRQoL instruments can be used to assess the impact of skin‐related problems in SC. The TFs encourage further studies to validate HRQoL instruments for use in different stages of SC, in order to allow more detailed practical recommendations on HRQoL assessment in SC. [ABSTRACT FROM AUTHOR]

Summary: Clinical question/scenario: Can therapy with clindamycin and rifampicin be safely continued long term beyond the recommended 10‐week course? Background: Clindamycin and rifampicin are used in combination to treat hidradenitis suppurativa (HS). There is no data on the efficacy and safety of clindamycin/rifampicin combination therapy for HS beyond 10 weeks. Methods: We identified the following major concerns that still lack a proper evidenced‐based analysis: for rifampicin, drug‐induced liver injury, interstitial nephritis, drug interaction and hepatic p450 3A4 enzyme induction; for clindamycin, the concern was community‐acquired Clostridium difficile infection (CA‐CDI); and experience with long‐term treatment. Data sources were used as appropriate to answer the question. Systematic searches were used to assess the risk of CA‐CDI and experience with long‐term treatment with clindamycin. Results/identified evidence: The risk for rifampicin‐induced liver injury is highest in the first 6 weeks of treatment, whereas interstitial nephritis is primarily observed during intermittent treatment. Enzyme induction due to rifampicin is usually complete after about 2 weeks of treatment and reduces clindamycin blood levels by about 90%. Three meta‐analyses identified antibiotic use as a risk factor for CA‐CDI. Two of them assigned the highest risk to clindamycin. None of them stratified by length of treatment. There is extensive experience with rifampicin, primarily for the treatment of tuberculosis. Long‐term experience with clindamycin is limited. Discussion and recommendation for clinical care: The analysed risks associated with a combination of clindamycin and rifampicin for hidradenitis suppurative cluster within the first 10 weeks. Treatment can be continued beyond 10 weeks, if clinically necessary. Linked Comment:Hambly and Kirby. Br J Dermatol 2019; 180:702–703. [ABSTRACT FROM AUTHOR]

Summary: Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflamed nodules. No pathognomonic test is available for HS; hence the diagnosis is based on three clinical criteria. Objectives: To estimate the cross‐sectional prevalence and characterize patients with HS in the Danish Blood Donor Study cohort. Methods: A questionnaire previously developed containing HS screening questions, the Major Depression Inventory, the Short Form‐12, as well as questions about height, weight and drinking habits was answered by 27 765 blood donors. Results: The prevalence of HS was 1·8% [95% confidence interval (CI) 1·6–2·0%] in the cohort of Danish blood donors. Donors with HS were on average 4·7 years younger (P < 0·001), had 1·3 kg m−2 higher mean body mass index (BMI) (P < 0·001) and were significantly more likely to smoke [odds ratio (OR) 1·44, 17·9% vs. 13·1%, P = 0·002] compared with donors without HS. Furthermore, significantly more donors with HS were classified as having moderate depression (3·2% vs. 0·7%, P < 0·001). Also, significantly more patients with HS were apprenticeship educated, received educational support and sickness or cash benefits. Conclusions: The prevalence of HS in the cohort of blood donors was estimated to 1·8% (95% CI 1·6–2·0%). Donors with HS reported characteristics similar to those reported for hospital‐based patients with HS such as higher BMI, smoking rates and lower socioeconomic status than donors without HS. What's already known about this topic? The population prevalence of hidradenitis suppurativa (HS) is estimated at between 1% and 4%.It is suspected that patients with HS have a lower socioeconomic status.Patients with HS are prone to depression and anxiety. What does this study add? The prevalence of HS in a population of Danish blood donors was estimated to be 1·8% (95% confidence interval 1·6–2·0%).Blood donors with HS have a lower socioeconomic status based on job description, but HS does not seem to affect personal income, after adjusting for age and sex.HS increases the risk of depression, even in a cohort of presumably mildly affected blood donors. Linked Comment:Shalom and Cohen. Br J Dermatol 2019; 180:712–713. Respond to this article Plain language summary available online [ABSTRACT FROM AUTHOR]

Background: Patients with moderate‐to‐severe psoriasis require long‐term treatment, yet few trials compare outcomes beyond a short‐term induction period. Quantitative comparisons of long‐term outcomes in patients with psoriasis are limited. To our knowledge, no network meta‐analysis (NMA) of such data has been performed. Objective: To compare novel systemic therapies, both biologic and non‐biologic, approved for moderate‐to‐severe psoriasis by conducting a systematic review (SR) and NMA of Psoriasis Area and Severity Index (PASI) outcomes measured at or around 1 year. Methods: An SR was conducted to identify studies reporting PASI 75, PASI 90 and PASI 100 responses. Feasibility of an NMA on maintenance phase endpoints was assessed and sources of heterogeneity considered. Data appropriate for analysis were modelled using a Bayesian multinomial likelihood model with probit link. Wherever possible, data corresponding to an intention‐to‐treat approach with non‐responder imputation were used. Results: Twenty‐four studies reporting outcomes at 40–64 weeks were identified, but heterogeneity in study design allowed synthesis of only 17. Four 52‐week randomized controlled trials (RCTs) comprised the primary analysis, which found brodalumab was significantly more efficacious than secukinumab, ustekinumab and etanercept. Secukinumab was also more efficacious than ustekinumab and both outperformed etanercept. In a secondary analysis, evidence from 13 additional studies and 4 further therapies (adalimumab, apremilast, infliximab and ixekizumab) was included by comparing long‐term outcomes from active interventions to placebo outcomes extrapolated from induction. Results were consistent with the primary analysis: brodalumab was most effective, followed by ixekizumab and secukinumab, then ustekinumab, infliximab and adalimumab. Etanercept and apremilast had the lowest expected long‐term efficacy. Results were similar when studies with low prior exposure to biological therapies were excluded. Conclusion: Results suggest that brodalumab is associated with a higher likelihood of sustained PASI response, including complete clearance, at week 52 than comparators. Further long‐term active‐comparator RCT data are required to better assess relative efficacy across therapies. [ABSTRACT FROM AUTHOR]

Background Patients with hidradenitis suppurativa ( HS) have an increased prevalence of traditional cardiovascular risk factors. Objective Our aim was to investigate the association between subclinical atherosclerosis, detected by carotid ultrasound, and HS. Methods A prospective observation and analytical study assessing subclinical atherosclerosis using carotid ultrasound in patients with HS. Results A total of 62 HS patients and 62 matched controls were studied. Diabetes mellitus (22.6% vs. 6.5%, P = 0.020), hypertension (41.9% vs. 12.9%, P < 0.001) and metabolic syndrome (MetS) (38.7% vs. 8.1%, P < 0.001) were more common in HS patients. Elevated neutrophil-to-lymphocyte ratio (59.7% vs. 40.3%, P = 0.031), high-sensitivity C-reactive protein (61.1 vs. 29.0%, P < 0.001) and erythrocyte sedimentation rate (46.8% vs. 9.7%, P < 0.001) were more frequent in patients with HS. Subclinical atherosclerosis was present in 30.6% of HS patients and in 16.1% of the controls subjects ( P = 0.06). After a logistic regression analysis, elevated age was associated with the presence of subclinical atherosclerosis ( P < 0.001), and HS showed a tendency towards this association [adjusted OR (95% CI) 3.8 (0.9-16.0), P = 0.066]. This association was statistically significant between patients 40 years and older [ OR (95% CI) 4.9 (1.8-13.1)]. Conclusions Our clinical results indicate that patients with HS have a higher prevalence of subclinical atherosclerosis than expected when correcting for traditional risk factors. The findings support the conclusions of previous epidemiological studies. [ABSTRACT FROM AUTHOR]

Background Chronic nonhealing or recurrent inflammatory lesions, reminiscent of infection but recalcitrant to antibiotic therapy, generally characterize biofilm-driven diseases. Chronic lesions of hidradenitis suppurativa ( HS) exhibit several characteristics, which are compatible with well-known biofilm infections. Objectives To determine and quantify the potential presence of bacterial aggregates in chronic HS lesions. Methods In 42 consecutive patients with HS suffering from chronic lesions, biopsies were obtained from lesional as well as from perilesional skin. Samples were investigated using peptide nucleic acid-fluorescence in situ hybridization in combination with confocal laser scanning microscopy. In addition, corresponding histopathological analysis on haematoxylin and eosin slides was performed. Results Biofilms were seen in 67% of the samples of chronic lesions and in 75% of the perilesional samples. The mean diameter of aggregates in lesional skin was significantly greater than in perilesional skin ( P = 0·01). Large biofilms (aggregates > 50 μm in diameter) were found in 42% of lesional samples and in only 5% of the perilesional samples ( P = 0·009). The majority of the large biofilms were situated in sinus tracts (63%) or in the infundibulum (37%). The majority of the sinus tract samples (73%) contained active bacterial cells, which were associated with inflammation. Conclusions This study suggests that biofilm formation is associated with inflammation of chronic HS lesions. The aggregates most likely occur as a secondary event, possibly due to predisposing local anatomical changes such as sinus tracts (tunnels), keratinous detritus and dilated hair follicles. [ABSTRACT FROM AUTHOR]

Background Chronic inflammatory diseases may be associated with anaemia of inflammation. Hidradenitis suppurativa is a chronic inflammatory dermatological disease associated with metabolic comorbidities, low quality of life and fatigue. Anaemia may cause fatigue, and it has been hypothesized that HS-related fatigue may be partly due to anaemia. Objective Our objective was to investigate a possible association between HS and anaemia. Methods We performed a hospital-based and population-based cross-sectional study investigating the red blood cell profile, i.e. haemoglobin. Results We identified a total of 32 hospital HS individuals, 430 population HS individuals and 20,780 population non- HS control individuals. The age-sex-smoking-adjusted analyses showed no differences in the haemoglobin level of the HS groups vs. the control group. Analyses of the anaemic subgroup of HS individuals revealed that 60% had normocytic anaemia and 40% microcytic anaemia, in concordance with anaemia of inflammation. Conclusion In contrast to our hypothesis, this study showed that HS is not associated with anaemia. Thus, anaemia may not be the cause of the described fatigue in HS patients. Furthermore, the results indicate that if an HS patient does suffer from anaemia it is most likely to be normocytic or microcytic and thus compatible with anaemia seen in other chronic inflammatory disorders. [ABSTRACT FROM AUTHOR]

Background Several studies have suggested an association between Hidradenitis Suppurativa (HS) and obesity. Obesity is often expressed as Body Mass Index ( BMI). However, BMI lacks information on body composition. General obesity is a predictor of health status and cardiovascular risk, but body composition (e.g. abdominal fat) may be more so. Basal metabolic rate ( BMR) is an expression of resting metabolism and may serve as a complementary tool when assessing the possibly underlying metabolism behind a persons' body composition. Objective To investigate the body composition and basal metabolic rate in individuals with HS compared with healthy controls. Methods We performed a cross-sectional study on both a hospital-based and population-based HS group and compared with controls using Bioelectrical Impedance Analysis to assess body composition. Results We identified a hospital-based HS group of 32 hospital HS patients, a population-based HS group of 430 population HS patients, and 20 780 controls. Age- and sex-adjusted analyses showed a 10.12% ( P < 0.0001) significantly higher fat percentage in the hospital-based HS group and 3.11% ( P < 0.0001) significantly higher fat percentage for the population-based HS group compared to controls. Correspondingly, the HS groups had a lower muscle percentage ( P < 0.0001) and lower bone mass percentage ( P < 0.0001). Furthermore, visceral fat rating ( P < 0.0001), Body Mass Index ( P < 0.0001), waist circumference ( P < 0.0001), and Waist/Hip Ratio ( P < 0.0001) was significantly higher in HS patients compared with controls. Additionally, age and sex-adjusted analyses showed a higher predicted estimate of BMR for the HS groups compared with controls (154.56 kcal/day (95% CI 54.96-254.16) ( P = 0.0031) for the hospital-based HS group, and 82.63 kcal/day (95% CI 59.70-105.56) ( P < 0.0001) for the population-based HS group). Conclusion Hidradenitis Suppurativa is associated with a high fat percentage, high visceral fat, and low muscle percentage adding to the morbidity of HS. The higher predicted estimate of basal metabolic rate ( BMR) in HS patients may reflect a dysfunctional metabolism contributing to the high-fat-body composition. [ABSTRACT FROM AUTHOR]

Background Collagen deposition disorders such as hypertrophic scars, keloids and scleroderma can be associated with significant stigma and embarrassment. These disorders often constitute considerable impairment to quality of life, with treatment posing to be a substantial challenge. Optical coherence tomography (OCT) provides a non-invasive, easily applicable bedside optical imaging method for assessment of the skin. It is hypothesized that OCT imaging may be useful in assessing fibrosis to avoid additional biopsies that could potentially worsen the scarring. Method Thirty-three patients with ordinary scars, hypertrophic scars, keloid scarring, lichen sclerosus et atrophicus and localized or systemic scleroderma were recruited for this pilot study . Affected tissue and adjacent healthy skin were scanned using OCT and digitally photographed. Density measurements were performed in ImageJ on OCT images from scleroderma patients, both systemic and morphea (10 patients), keloid patients (10 patients) and healthy skin adjacent to keloids (10 patients). Results OCT images of scarring diseases showed varying degrees of disruption to the skin architecture. OCT characteristics were identified for each lesion type. Hypertrophic scars displayed an increased vascularity and signal-rich bands correlating to excessive collagen deposition. Keloids depicted a disarray of hyper-reflective areas primarily located in the upper dermis. Additionally, the dermis displayed a heterogeneous morphology without indications of any vascular supply or lymphatic network. In contrast to keloids, scleroderma displayed a more cohesive backscattering indicating a difference in density of collagen or other dermal structures. OCT images demonstrated no significant differences between mean density measurements in OCT images of scleroderma, keloid and healthy skin ( P = 0.07). Conclusion The OCT imaging appears to identify different scarring mechanisms, and therefore be of potential use in the assessment of outcomes following non-invasive therapy of e.g. early or progressive lesions. [ABSTRACT FROM AUTHOR]

Background Psoriasis (PS) has been suggested to be associated with the metabolic syndrome (MetS) in numerous studies with conflicting results. The vast majority of previous data were based on PS subjects from hospitals, and when based on data from the general population the PS subjects were often identified in insurance health databases. Furthermore, many studies used a single method approach, e.g. self-reported diagnosis. Objective We have therefore investigated a possible association between PS and MetS on PS subjects from the hospital as well as the general population using combined methods, i.e. self-reported diagnosis, physical examinations and blood samples. Methods A population- and hospital-based cross-sectional study of the possible association between PS and MetS. Results Thirty-six hospital PS subjects, 860 population PS subjects and 14 016 non-PS subjects were identified. The odds ratios (ORs) for hospital PS subjects and population PS subjects vs. population non-PS subjects, respectively, were 5.14 (2.47-10.69) and 1.29 (1.09-1.53) for MetS, 4.55 (1.91-10.85) and 1.16 (0.85-1.59) for diabetes, 1.92 (0.87-4.22) and 1.00 (0.86-1.17) for hypertension, 4.34 (1.86-10.10) and 1.15 (1.00-1.34) for hypertriglyceridaemia, 3.88 (1.96-7.69) and 1.19 (1.01-1.42) for hypoHDL, 5.77 (2.89-11.52) and 1.19 (1.00-1.41) for general obesity and 2.92 (1.45-5.88) and 1.34 (1.16-1.55) for abdominal obesity. Obesity acted as a possible confounder. A uniform pattern of higher ORs for hospital PS subjects when compared to population PS subjects was observed. The severity and duration of PS did not seem to affect the results. As this is a cross-sectional study we cannot demonstrate causality. Conclusion The data suggested an association between PS and MetS as well as its individual parameters on a hospital-based level, with the exception of hypertension. On a population-based level the associations were only significant for MetS, hypoHDL and abdominal obesity. [ABSTRACT FROM AUTHOR]

The objective of this study was to test the safety and efficacy of a fully human monoclonal anti-CD4 antibody (HuMax-CD4) in the treatment of psoriasis. HuMax-CD4 is a fully human [...]

Quantitative morphological studies of the healthy epidermis are essential in providing a range of parameter estimates that can be considered within the range of normality. Stereology is a set of statistical tools that provides potentially unbiased and precise estimates of 3-dimensional tissue characteristics from 2-dimensional sections. We set out to establish reference values for the volume of the viable epidermis contained within a four-millimetre punch biopsy (Vepi), the volume of the stratum corneum (VSC) and the surface area of the dermo-epidermal junction(ADEJ) in 4 predetermined body regions by use of stereology. Four-millimetre punch biopsies were taken from 20 freshly diseased corpses, fixed in formalin and embedded in paraffin. Vepi, VSC and ADEJ were established stereologically for all 4 body locations followed by pairwise comparison of means after Bonferroni correction. Vepi was significantly larger in the sole compared to all other body locations (p < 0.01). Furthermore, linear regression analysis showed a strong linear relationship between Vepi and VSC in the sole (r = 0.70). Our results suggest that the viable layers of the epidermis might also serve a mechanical function, either directly or by providing the stratum corneum with keratinocytes to support the hyperkeratosis in the weight-bearing parts of the skin. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Peristomal skin problems are common and are treated by a variety of health professionals. Clear and consistent communication among these professionals is therefore particularly important. The Ostomy Skin Tool (OST) is a new assessment instrument for the extent and severity of peristomal skin conditions. Formal tests of reliability and validity are necessary for its use in clinical practice, research, and education. To estimate inter- and intra nurse assessment variability of the OST and validity by comparison to a 'gold standard' (GS) defined by an expert panel. Thirty photographs of peristomal skin were presented twice to 20 ostomy care nurses - 10 from Denmark (DK) and 10 from Spain (ES) - to determine intra- and inter nurse assessment variability. The same photographs were presented to an international group of experts (dermatologist and ostomy care nurses), to establish a GS for comparison and validation of the results. A high intra-nurse assessment agreement, κ = 0·84, was found with no differences in the intra-nurse assessments from the two groups of nurses (DK and ES). The inter-nurse assessment agreement was 'moderate to good', κ = 0·54, with the agreement between the experts higher, κ = 0·70. A high correlation between the scores from the nurses and the GS were seen in the lower part of the two scales [Discoloration, Erosion, Tissue overgrowth (DET) score < 7)]. The study supported the validity of the OST. It is suggested that a categorical scale can be used to illustrate the severity of the DET scores. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on creation of European registry for hidradenitis suppurativa/acne inversa.

A letter to the editor is presented concerning self-reported pain management in hidradenitis suppurativa.

Linked Article: Albrecht et al. Br J Dermatol 2019; 180:749–55. [ABSTRACT FROM AUTHOR]

Summary: 化脓性汗腺炎 (HS) 是一种慢性皮肤疾病。它会使特定身体部位(如腋窝和腹股沟)出现疼痛性疖疮。在英国约有 1% 的人发生这种疾病。它在女性中更常见。HS 会引起疼痛, 但很少有研究分析这一方面。抑郁和焦虑会影响疼痛的经历。患者的年龄和性别也会影响疼痛的经历。 作者们旨在研究 HS 患者的疼痛。他们在丹麦罗斯科德的 HS 专家诊所分发调查问卷(2017 年 10 月至 2018 年 3 月)。患者描述了他们的 HS 疼痛和困难, 并报告了任何抑郁和焦虑症状。 描述疼痛的词语有所不同。最常见的词语是"闪痛"(83%)、"瘙痒"(79%) 和"剧痛"(75%)。研究表明 HS 疼痛与 HS 严重程度以及焦虑和抑郁症状相关。 作者们发现, HS 患者的疼痛经历可分为两种不同的疼痛性质:所谓的伤害性和神经性疼痛。这两种疼痛类型通常使用不同的药物治疗: 抗炎药(如阿司匹林)和抗抑郁药。 一般而言, HS 患者比其他人更容易抑郁。不同的止痛药(包括抗炎药物和抗抑郁药)可能会对治疗 HS 患者的疼痛有效。但是, 需要更多研究来确定治疗 HS 疼痛的明确建议。 This summary relates to the study: 化脓性汗腺炎患者的疼痛感知 Linked Article: Nielsen et al. Br J Dermatol 2020; 182:166–174 [ABSTRACT FROM AUTHOR]

Summary: Hidradenitis suppurativa (HS) is a chronic skin disease. It causes painful boils in specific body areas such as the armpits and the groins. This disease affects about 1% of people in the U.K. It is more common in women. HS causes pain, but few studies have looked at this aspect. Depression and anxiety affects how pain is experienced. The patient's age and sex can also influence the experience of pain. The authors aimed to study pain in patients with HS. They handed out questionnaires in a HS specialist clinic in Roskilde, Denmark (Oct 2017 – Mar 2018). Patients described their pain and difficulty of HS, and reported any symptom of depression and anxiety. Pain was described with different words. The most common words were 'shooting' (83%), 'itchy' (79%) and 'blinding' (75%). The study revealed that pain in HS relates to severity of HS and to symptoms of anxiety and depression. The authors found that the pain experience of HS patients can be divided into two different pain qualities: the so‐called nociceptive and neuropathic pain. These two pain types are usually treated with different medications: anti‐inflammatory drugs (e.g. aspirin) and antidepressants. In general, HS patients are more often depressed than other people. HS patients are likely to benefit from different pain relievers including both anti‐inflammatory drugs and antidepressants to treat their pain. However, more studies are needed to make definite recommendations on treatment of HS pain. This summary relates to the study: Pain perception in patients with hidradenitis suppurativa Linked Article: Nielsen et al. Br J Dermatol 2020; 182:166–174 [ABSTRACT FROM AUTHOR]

Linked Article: Theut Riis et al. Br J Dermatol 2019; 180:774–781 [ABSTRACT FROM AUTHOR]

Summary: Hidradenitis suppurativa (HS) is a distressing skin condition in which patients suffer from repeated eruptions of boils in the armpit, groin, under the breast, and in the perineum. The disease is suspected to affect around 1 in 100 people, but studies are conflicting on how many actually suffer from this disease. The unique nature of the disease makes it possible to diagnose the disease using questionnaires. Danish blood donors received the questionnaire, and 27,765 answered it. Approximately 1.8 % (almost 1 in 50) of blood donors seemed to suffer from HS. Donors with HS had a higher body mass index and were younger than donors without; female to male ratio was approximately 1:1. Smoking frequency and body mass index of donors with HS were between that of blood donors without HS and patients with HS from other studies. The questionnaire also revealed that HS patients were more depressed, but their life quality was the same as non‐HS donors. The unique civil registration number in Denmark allowed us to compare publicly registered information about the participants. More HS donors received educational support and cash benefits (both are government support) than non‐HS donors. HS did not, however, seem to affect income of donors. Only 2.2 % of the HS donors were registered with the disease. We interpreted this as a need for better diagnosis of mild cases of the disease. If the blood donors continue to give blood, we can follow them to see how much their HS condition affects their life. Linked Article: Theut Riis et al. Br J Dermatol 2019; 180:774–781 [ABSTRACT FROM AUTHOR]

A letter to the editor is presented that discusses imaging of cutaneous T-cell lymphomas by optical coherence tomography.