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Background. Pain is one of the main aspects of hidradenitis suppurativa that strongly affects the quality of life of patients. We explored the relationship between pain and clinical severity as well as its role in defining the health status in patients with HS. Methods. Pain was defined by three measures: (a) question 1 (“my skin hurts”) of the Skindex-17, (b) Bodily Pain (BP) scale of the SF-36, and (c) Visual Analog Scale (VAS). Clinical severity of HS was assessed by the Hurley staging, the Sartorius HS Score, and the International HS Severity Score System. Results. The study population included 341 HS patients with complete data for the VAS pain, 316 for question 1 of the Skindex-17, and 294 for BP. Clinical severity was positively associated with pain. This result was observed for all three severity scores and all three pain evaluation methods. In addition, the number of fistulae, abscesses, and nodules were significantly associated with the three severity measures of pain, while the association with scars was not observed for question 1 of the Skindex-17 and BP. Conclusions. Pain may be a good proxy of clinical severity and efficacy of a treatment in HS and therefore a crucial hallmark of patients’ health status.

Health-related quality of life (HRQoL) in psoriasis patients is generally measured using disease- or dermatology-specific questionnaires. Our objective was to use the generic 12-item Short Form Health Survey (SF-12) instrument to measure the physical and mental impact of psoriasis and to compare scores with those already published for different diseases. An observational study was conducted among mild-to-severe psoriasis outpatients. Health status was assessed by the SF-12, which includes a physical (PCS) and a mental (MCS) scale. The 12-item General Health Questionnaire (GHQ-12) was used to assess the possible presence of depression or anxiety, and the Skindex-17 to measure dermatology-specific HRQoL. Statistical analyses were performed to estimate the association between physical and mental health status and demographic and clinical characteristics. The study population included 1592 patients. Psoriasis PCS scores were similar to the general population and to non-severe diseases such as allergies, dermatitis, or back pain, while MCS mean scores were very similar to that of depression, and lower than those of all the other chronic conditions. Poor physical health was associated with female sex, older age, lower educational level, joint involvement, ≥2 comorbidities, moderate to very severe clinical status, GHQ-12 score ≥4, and moderate to severe Skindex-17 psychosocial scores. Poor mental health was associated with younger age (

Introduction L’hidradenite suppuree (HS) a generalement un debut precoce, mais peut egalement survenir apres 40 ans. Recemment, le seuil de 28 ans pour distinguer les patients a debut precoce et tardif a ete propose. L’objectif de l’etude etait de comparer la qualite de vie et la detresse psychologique chez les patients atteints d’HS precoce et tardive. Materiel et methodes Dans cette etude observationnelle transversale, des patients consecutifs ayant un diagnostic d’HS âges de 16 ans ou plus ont ete recrutes. Des donnees sociodemographiques et cliniques ont ete recueillies. La qualite de vie a ete evaluee a l’aide du questionnaire Skindex-17 specifique pour la dermatologie. La detresse psychologique a ete evaluee a l’aide du General Health Questionnaire (GHQ-12). Les patients ont ete classes en « debut precoce » ( Resultats Les donnees ont ete recueillies chez 467 patients. L’âge moyen au diagnostic etait de 21,6 ans, avec 22 % des patients ayant une apparition tardive de la maladie. Ces patients avaient une plus mauvaise qualite de vie psychosociale mesuree par le Skindex-17, en particulier pour la vie sociale et sexuelle, et une detresse psychologique plus elevee selon le GHQ-12 par rapport a une apparition precoce. Les scores psychosociaux moyens du Skindex-17 chez les patients a debut tardif par rapport a ceux a debut precoce etaient significativement plus eleves dans les categories suivantes : femmes, niveau scolaire 9–13 ans, fumeurs, duree de la maladie plus courte, moins de retard de diagnostic, pas d’antecedents familiaux, pas de comorbidites, localisation sous les aisselles, deux ou plusieurs localisations. L’apparition tardive etait significativement associee a un âge plus eleve au moment du recrutement, une duree de maladie plus courte, moins de retard de diagnostic, un nombre plus eleve de fistules, un IMC plus eleve, sexe masculin, ancien fumeur et presence de psoriasis. L’apparition precoce etait associee aux antecedents familiaux et a la localisation dans la region mammaire et sous les aisselles. Aucune difference entre les patients a debut precoce et tardif n’a ete observee pour la severite clinique. Discussion L’impact psychosocial de l’HS est plus eleve chez les patients avec apparition tardive de la maladie par rapport a un debut precoce. Les differences entre les patients presentant une HS tardive et precoce devraient etre approfondies.

Depression is frequent in patients with hidradenitis suppurativa. However, its relationship with quality of life and clinical severity needs further investigation. In this cross-sectional study, 341 adult, consecutive patients with hidradenitis suppurativa completed the 12-item General Health Questionnaire (GHQ-12), which has been shown to be able to identify cases of major depressive disorder in dermatological patients. The frequency of depression in hidradenitis suppurativa patients was 29.0%. In patients with depression, severity (International Hidradenitis Suppurativa Severity Score System (IHS4)), quality of life (Skindex-17; Dermatology Life Quality Index (DLQI)), and health status (36-item Short Form Health Survey (SF-36)) were significantly worse compared with patients with no depression. The highest linear correlation was observed between GHQ-12 and the psychosocial scale of the Skindex-17 and the SF-36 mental scale. In contrast, correlation between GHQ-12 and clinical severity was poor. Depression is an important comorbidity in hidradenitis suppurativa, which is strongly associated with impairment in quality of life, but not linearly correlated with clinical severity.

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.