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Patients with hidradenitis suppurativa experience significant life impact related to their disease. Younger age, Black race, high BMI, active smoking, flares, depression, anxiety, high comorbidity burden, disability, and difficult access to a dermatologist adversely influence life impact related to having hidradenitis suppurativa. Attention to these factors, particularly modifiable ones, may reduce overall impact of disease.

Current validated hidradenitis suppurativa (HS) severity assessment tools are time-consuming and impractical in fast-paced, ambulatory clinic settings. This study evaluated the construct validity of the most severe or “worst” area local Hidradenitis Suppurativa Activity and Severity Index-Revised (W-HASI-R) as a novel target area assessment tool for clinical setting use. W-HASI-R had strong association with International Hidradenitis Suppurativa Severity Score System and abscess-nodule count, moderate association with Hurley stage and HS physician global assessment and weak, negative association with reverse-scored dermatology quality life index. Resulting data suggests that W-HASI-R may be an option as an efficient target area assessment tool for fast-paced, ambulatory settings.

Skin thickness, as known as inflammatory induration, is a component in several HS grading instruments including the HASI and HASI-R. This study sought to evaluate how thickest lesion measurement (mm) corresponds to HS severity. This study demonstrates that inflammatory induration has moderate association with HS severity, thickest lesion measurement (mm) demonstrates known-validity across Hurley stages, and cut-offs for thickest lesion measurement (mm) were determined for inflammatory induration grading for the purpose of HASI-R training.

BACKGROUND Validated, reliable, globally accepted outcome measurement instruments for hidradenitis suppurativa (HS) are needed. Current tools to measure the physical signs domain for HS rely on lesion counts, which are time-consuming and unreliable. OBJECTIVES To assess the reliability and validity of the Hidradenitis suppurativa Area and Severity Index Revised (HASI-R) tool, a novel method for assessing HS severity, incorporating signs of inflammation and body surface area involved. METHODS The measurement properties of the HASI-R tool were evaluated. The tool was created by combining the previously published HASI and Severity and Area Score for Hidradenitis instruments. Twenty raters evaluated 15 patients with HS in a hospital-based ambulatory dermatology clinic. The objectives of the study were to assess inter- and intra-rater reliability of the HASI-R and its components, as well as its construct and known-groups validity. Existing lesion count-based clinician-reported measures of HS and their components were also assessed. Raters were also asked their preferences regarding the various HS severity assessment tools. RESULTS The HASI-R had moderate inter-rater reliability [intra-class correlation coefficients (ICC) 0·60]. This was better than all other HS physical sign outcome measures evaluated, which had poor inter-rater reliability (ICC

Hidradenitis suppurativa (HS) is a chronic inflammatory condition which affects apocrine gland-rich skin.1 It primarily develops in intertriginous areas, including the axilla, groin, perianal, and perineal regions and presents with recurrent, painful nodules, abscesses, draining tunnels, and scarring.1 Despite the continuing research and development of biologics for HS, biologics can lead to the formation of anti-drug antibodies (ADAs) that inactivate the therapeutic effects of the treatment, leading to a decreased drug level and resulting in a suboptimal response.2.

Hidradenitis suppurativa (HS) is a condition that commonly presents with recurrent abscesses, nodules, and draining tunnels. Despite drainage and odor occurring as common symptoms that are associated with poorer quality of life, and patients included in the Hidradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC) highly supported that drainage should be recommended in the core domain set, there are no validated instruments to measure drainage.