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Krajewski PK, Strobel A, Schultheis M, Staubach P, Grabbe S, Hennig K, Matusiak L, von Stebut E, Garcovich S, Bayer H, Heise M, Kirschner U, Nikolakis G, Szepietowski JC. Hidradenitis Suppurativa Is Associated with Severe Sexual Impairment. Dermatology 2024; 240:205-215. [PMID: 38190809 DOI: 10.1159/000536128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/25/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the pilosebaceous unit, often affecting and deforming intimate regions. HS is associated with severe pain, pruritus, and constant, purulent, malodorous discharge expected to impair sexual health of patients. METHODS We performed a cross-sectional, multicentric study involving 199 German patients from the health services research project "Epidemiology and Care in Acne inversa (EpiCAi)." The sexual health, HS severity, and quality of life of the studied group were evaluated using a specially designed questionnaire. RESULTS Regardless of gender, HS has an enormous impact on patients' sexual health. The patients scored, on average, 28.8 ± 5.3 points on the Relation and Sexuality Scale (RSS). Multiple linear regression revealed that females and patients with Hurley III stage had higher sexual dysfunction (p = 0.012). Sexual dysfunction is associated with pain (β = 0.25), the number of active lesions, the affected areas (β = 0.14), and psychosocial aspects, including low quality of life (β = 0.404), stigmatization (β = 0.411), depression (β = 0.413), and anxiety (β = 0.300). Patients already see a substantial decrease in sexual frequency in the early stages of HS, while functional impairment and fear increase with the severity of the disease. CONCLUSION Sexual health and management of its dysfunctions should be part of a holistic approach to HS patients.
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Affiliation(s)
- Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Alexandra Strobel
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/, Saale, Germany
- Profile Centre of Health Sciences Halle, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/, Saale, Germany
| | - Michael Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Katharina Hennig
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | | | - Hans Bayer
- Dermatology Outpatient Office Hautmedizin Bad Soden, Bad Soden, Germany
| | - Marcus Heise
- Profile Centre of Health Sciences Halle, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/, Saale, Germany
- Institute for Health- and Nursing Science, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/, Saale, Germany
- Institute of General Practice and Family Medicine, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/, Saale, Germany
| | - Uwe Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, Mainz, Germany
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Kimball AB, Kirby J, Ingram JR, Tran T, Pansar I, Ciaravino V, Willems D, Lewis-Mikhael AM, Tongbram V, Garg A. Burden of Hidradenitis Suppurativa: A Systematic Literature Review of Patient Reported Outcomes. Dermatol Ther (Heidelb) 2024; 14:83-98. [PMID: 38183616 PMCID: PMC10828455 DOI: 10.1007/s13555-023-01085-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) has a profound negative impact on patients' health-related quality of life (HRQoL). Here we summarize the evidence on HRQoL and Patient Reported Outcomes (PROs) in patients with HS in real-world settings by conducting a systematic literature review (SLR) of observational studies. METHODS Data sources included MEDLINE, Embase & PsycINFO between January 1, 2010 and August 29, 2021, and conference proceedings between 2019 and 2021. Identified abstracts were reviewed and screened independently by two reviewers. Eligibility criteria included patients with HS of any severity, sample size ≥ 100, reporting PROs including HRQoL measures. Included studies were critically appraised. RESULTS Fifty-eight observational studies matched inclusion criteria. Dermatology Life Quality Index (DLQI) was the most commonly utilized instrument: 57% of included studies reported mean baseline DLQI scores, ranging between 8.4 and 16.9, indicating a very large impact on the patients' HRQoL. Higher scores were reported with increasing disease severity and among female patients. Pain was assessed mostly by an 11-point (0-10) numeric rating scale (NRS) with a mean baseline score ranging from 3.6 to 7.7 indicating moderate to high pain levels. There was a negative impact of HS on patients' psychological well-being, based on PRO scores related to depression and anxiety. A high proportion of sexual dysfunction was reported, with a larger impact on women than men. Work productivity and leisure activity were consistently found to be impaired in patients with HS. CONCLUSIONS All included studies reported a negative impact of HS on patients' lives. A diverse set of disease- and non-disease-specific PRO instruments were utilized highlighting the need for more consistent use of HS-specific validated PRO instruments to assess the impact of HS on the different aspects of patients' HRQoL to allow for data to be more meaningfully interpreted and compared in real-world settings. Patients with HS need better disease management approaches that address the observed low quality of life.
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Affiliation(s)
- Alexa B Kimball
- Harvard Medical School and Beth Israel Deaconess Medical Center Boston, Boston, MA, USA.
| | | | | | | | | | | | | | | | | | - Amit Garg
- Northwell Health, New Hyde Park, New York, NY, USA
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Masson R, Shih T, Park S, De DR, Gierbolini A, Alavi A, Garg A, Micheletti RG, Shi VY, Hsiao JL. Patient Perspectives on Hidradenitis Suppurativa and Infertility: A Survey Study. Dermatology 2023; 239:732-737. [PMID: 37385230 PMCID: PMC10614271 DOI: 10.1159/000531727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is an inflammatory skin condition which predominantly affects women of childbearing age in the USA. There is a lack of research on the association between HS and fertility. OBJECTIVES The aim of this study was to understand the perspectives of females with HS regarding the impact of their disease on reproductive health, the impact of fertility treatments on HS, and the impact of HS treatments on fertility. METHODS An anonymous, online survey was disseminated through HS support groups from June to July 2022. Respondents aged 18-50 who were assigned female sex at birth were eligible for participation. Comparative statistics were performed using t tests/χ2 tests to assess associations between respondents' demographics and survey responses. RESULTS Among the 312 respondents (80.8% White, mean age 35.7 ± 7.4 [range 18-50]), two-thirds of respondents (66.6%, 207/311) had been pregnant before and 79.5% (248/312) had ever tried to conceive. 41.5% (103/248) had unsuccessfully tried to conceive for 12 months or more. Of the 59 respondents who had never attempted to conceive, 39% reported that HS had impacted this decision. Amongst respondents who experienced fertility challenges but did not pursue fertility treatments, top barriers to fertility treatments include concerns about financial support/insurance coverage (47.5%, 29/61) and fertility treatments worsening HS (21.3%, 13/61). Most respondents who used fertility treatments reported either no change (73.7%, 28/38 or 77.8%, 14/18) or improvement (15.8%, 6/38 or 11.1%, 2/18) in their HS symptoms with oral or injectable medications. Respondents were most concerned about the effects of oral antibiotics (44.9%, 140/312), followed by hormonal medications (38.8%, 121/312) and biologics (35.9%, 112/312) on fertility. CONCLUSION Females with HS reported high rates of infertility compared to the general population. The majority reported no change in HS symptoms with fertility treatments, and clinicians can use this finding to help counsel patients during family planning discussions. Further research in the field of HS and fertility is needed.
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Affiliation(s)
- Rahul Masson
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sarah Park
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Devea R. De
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Amit Garg
- Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Robert G. Micheletti
- Departments of Dermatology and Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivian Y. Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer L. Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
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Sánchez-Díaz M, Rodríguez-Pozo JÁ, Latorre-Fuentes JM, Salazar-Nievas MC, Alejandro ML, Arias-Santiago S. Sleep Quality as a Predictor of Quality-of-Life and Emotional Status Impairment in Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3508. [PMID: 36834203 PMCID: PMC9964690 DOI: 10.3390/ijerph20043508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Chronic Spontaneous Urticaria (CSU) leads to a decreased quality of life in patients because of pruritus and skin lesions. However, there is still little evidence on the impact that a worse sleep quality could have on the quality of life and emotional disorders in these patients. The aims of the present study are to analyze the potential impact of sleep quality on the quality-of-life and emotional status of patients with CSU. A cross-sectional study of 75 CSU patients was performed. Socio-demographic variables and disease activity, quality of life, sleep, sexual disfunction, anxiety, depression and personality traits were collected. A majority of 59 of the patients suffered from poor sleep quality. Sleep quality impairment was associated with worse disease control, greater pruritus and swelling and poorer general and urticaria-related quality-of-life (p < 0.05). Patients with poor sleep quality showed an increased prevalence of anxiety (1.62-fold) and depression risk (3.93-fold). Female sexual dysfunction, but not male, was found to be linked to poorer sleep quality (p = 0.04). To conclude, sleep quality impairment in patients with CSU is related to poor quality-of-life, worse disease control and higher rates of anxiety and depression. Global management of the disease should take sleep quality into account to improve the care of CSU patients.
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Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Juan Ángel Rodríguez-Pozo
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - José María Latorre-Fuentes
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Maria Carmen Salazar-Nievas
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
- Urticaria Clinic, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Molina-Leyva Alejandro
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18002 Granada, Spain
- Urticaria Clinic, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, 18071 Granada, Spain
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5
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Cuenca-Barrales C, Montero-Vilchez T, Krajewski PK, Szepietowski JC, Matusiak L, Arias-Santiago S, Molina-Leyva A. Sexual Dysfunction and Quality of Life in Patients with Hidradenitis Suppurativa and Their Partners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:389. [PMID: 36612709 PMCID: PMC9819626 DOI: 10.3390/ijerph20010389] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 05/13/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic skin disease that profoundly affects patients' quality of life (QoL) and sexuality. Few data are available on the impact of HS on patients' partners. We aimed to explore the QoL and sexual function of patients' partners and the factors associated with their impairment and to compare the QoL and sexual function of single patients and those in a stable relationship. We conducted a cross-sectional study at Hospital Universitario Virgen de las Nieves (Granada, Spain) and at the Wroclaw Medical University (Wroclaw, Poland). Patients over the age of 16 years attending their scheduled follow-up and their partners, if any, were included. The Dermatology Life Quality Index (DLQI) and the Family Dermatology Life Quality Index (FDLQI) were used to estimate the QoL of patients and partners, respectively. The FSFI-6 was used to determine sexual dysfunction in women and the IIEF-5 for erectile dysfunction in men. Thirty-four single patients and twenty-eight patients in a stable relationship and their partners were included. Patients had a very large impact (DLQI 12.5 ± 7.5) and their partners a moderate impact (FDLQI 10.3 ± 7.1) in their QoL due to HS. Women with HS had a high prevalence of sexual dysfunction (13/32, 40.6%) and men of erectile dysfunction (19/30, 63.3%). Male partners also had a high prevalence of erectile dysfunction (10/17, 58.8%), while only one female partner had sexual dysfunction (1/11, 9.1%). Factors related to disease severity, intensity of symptoms and body mass index were associated with poorer QoL in partners and time of disease evolution with greater erectile dysfunction in male partners. In conclusion, HS not only profoundly affects the QoL and sexuality of patients but also of their partners. Several risk factors have been identified, which should be taken into account in the holistic approach of the disease.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Trinidad Montero-Vilchez
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Salvador Arias-Santiago
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- School of Medicine, Department of Dermatology, University of Granada, 18016 Granada, Spain
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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6
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Sánchez-Díaz M, Díaz-Calvillo P, Ureña-Paniego CA, Molina-Leyva A, Arias-Santiago S. Quality of Life and Mood Status Disturbances in Cohabitants of Patients with Alopecia Areata: A Cross-Sectional Study in a Spanish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16323. [PMID: 36498394 PMCID: PMC9737113 DOI: 10.3390/ijerph192316323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
A poor quality of life has been described in patients suffering from Alopecia Areata (AA). However, there is little evidence on how AA can impact on those living with patients. The aim of this study is to analyze the impact of AA on a cohabitant’s quality-of-life, mood status disturbances and sexual satisfaction. This is a cross-sectional study of AA patients and their cohabitants. Socio-demographic variables and disease severity, the quality of life, mood status disturbances and sexual dysfunction were collected using validated questionnaires. Eighty-four subjects were included in the study: 42 AA patients and 42 cohabitants. A poor quality of life and worse disease control in the patients were associated with a poorer quality of life of the family, higher scores of anxiety and depression, and the lower sexual satisfaction of cohabitants (p < 0.05). Anxiety and depression in patients were associated with worse family quality of life, higher rates of anxiety and less sexual satisfaction in cohabitants (p < 0.05). To conclude, AA seems to have an impact on the quality of life of cohabitants, leading to increased rates of anxiety, depression, a poorer quality of life, and reduced sexual satisfaction. In light of the results, a global approach for AA patients, including the care of the people who live with them, should be implemented.
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Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18002 Granada, Spain
| | - Pablo Díaz-Calvillo
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18002 Granada, Spain
| | - Clara-Amanda Ureña-Paniego
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18002 Granada, Spain
| | - Alejandro Molina-Leyva
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18002 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18002 Granada, Spain
- Trichology Clinic, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, 18016 Granada, Spain
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7
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Varney P, Guo W, Brown M, Usmani H, Marquez J, Ayasse M, Kaufmann T, Haughton A. A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa. Int J Dermatol 2022; 62:737-746. [PMID: 35781695 DOI: 10.1111/ijd.16328] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 05/05/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with significant psychosocial comorbidity. To date, the relationship between HS and sexual dysfunction has not been assessed through meta-analysis. A systematic review was performed by OVID Medline, EMBASE, Cochrane Central, PsycINFO via EBSCO, Web of Science, and LILACS. Original English language studies assessing HS and sexual function published prior to April 2020 were screened. Scores from the Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF), Arizona Sexual Experiences Scale (ASEX), Frankfurt Self-Concept Scale for Sexuality (FKKS SEX), and Dermatology Life Quality Index (DLQI) were analyzed. Sixteen studies met inclusion criteria, and nine were eligible for meta-analysis. Pooled mean FSFI score for female HS patients met criteria for sexual dysfunction (mean = 20.32, P < 0.001). Females with HS reported worse FSFI scores than controls (pooled mean difference = -5.704, P = 0.003, I2 =0). Mean IIEF score among males with HS was 47.96 (P < 0.001). Males with HS also reported worse IIEF scores than controls (pooled mean difference = -18.77, P = 0.00, I2 = 0). Females with HS performed worse on sexual function inventories than males with HS (SMD = -0.72, P = 0.009, I2 = 0). Both male and female HS patients reported significantly more sexual impairment than same-sex controls. Female HS patients also experience more sexual impairment than males and on average meet criteria for sexual dysfunction (FSFI <26.55). Clinicians should be aware that their patients with HS, especially females, may be suffering from sexual dysfunction and treated them appropriately.
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Affiliation(s)
- Paige Varney
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
| | - William Guo
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Mikayla Brown
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Hunya Usmani
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Jocellie Marquez
- Department of Surgery, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Marissa Ayasse
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Tara Kaufmann
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Adrienne Haughton
- Department of Dermatology, Renaissance School of Medicine, Stony Brook, New York, USA
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8
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Sánchez-Díaz M, Salazar-Nievas MC, Molina-Leyva A, Arias-Santiago S. Type D Personality Is Associated with Poorer Quality of Life in Patients with Chronic Spontaneous Urticaria: A Cross-sectional Study. Acta Derm Venereol 2022; 102:adv00734. [PMID: 35470405 DOI: 10.2340/actadv.v102.676] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Type D personality (TDp) is a stable personality type that has been associated with poor quality of life in the general population and in patients with a variety of diseases, such as cancer, cardiac diseases, and dermatological diseases (e.g. psoriasis). To date, the potential association between chronic spontaneous urticaria and TDp has not been studied. The aim of this study is to analyse the impact of TDp on patients with chronic spontaneous urticaria, regarding mood disturbances, quality of life, sexuality, and sleep disturbances. A cross-sectional study including 75 patients with chronic spontaneous urticaria was performed. Data on socio- demographic variables and disease activity, quality of life, sleep, sexual dysfunction, anxiety, depression and TDp were collected using validated questionnaires. TDp was present in 28% (21/75) of the patients. Although TDp was not related to worse disease control, the presence of anxiety and depression was higher in patients with TDp. Regarding quality of life, TDp was associated with poorer quality of life and higher frequency of sleep disturbances. Prevalence of TDp in patients with chronic spontaneous urticaria is similar to that in the general population. It is associated with mood status disturbances and worse quality of life regardless of disease severity, especially in the emotional and psychological domains. This group of patients could benefit from additional psychological support as a complement to their medical treatment.
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The Burden on Cohabitants of Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11113228. [PMID: 35683614 PMCID: PMC9181347 DOI: 10.3390/jcm11113228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 12/18/2022] Open
Abstract
Chronic Spontaneous Urticaria (CSU) has been associated with patients’ poor quality of life. Despite being a chronic disease that could alter the quality of life of the people who live with patients, the potential burden on their cohabitants has not been studied to date. The aim of this study is to analyze the relationship between the patient’s quality of life, disease control, disease duration and family quality of life and the cohabitant’s mood disturbances, sexual dysfunction, type D personality and sleep quality. A cross-sectional study including patients suffering from CSU and their cohabitants was performed. Sociodemographic variables and disease activity, quality of life, sleep, sexual disfunction, anxiety, depression and type D personality were collected using validated questionnaires. Sixty-two subjects, 31 CSU patients and 31 cohabitants, were included in the study. Worse disease control and poorer quality of life in patients were associated with poorer family quality of life and higher rates of anxiety among the cohabitants (p < 0.05). Patients’ poor quality of life was associated with reduced sexual satisfaction among the cohabitants (p < 0.05). Long disease duration (>10 years) was associated with an increased prevalence of type D personality among the cohabitants (prevalence ratio: 2.59, CI 95% 1.03−7.21). CSU seems to have an impact on the quality of life of cohabitants, especially in terms of increased rates of anxiety, poorer quality of life and reduced sexual satisfaction. The prolonged course of the disease could be associated with the increased presence of non-adaptative personality traits.
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Kozera EK, Lowes MA, Hsiao JL, Frew JW. Clinical considerations in the management of hidradenitis suppurativa in women. Int J Womens Dermatol 2021; 7:664-671. [PMID: 35028361 PMCID: PMC8714605 DOI: 10.1016/j.ijwd.2021.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/20/2021] [Accepted: 10/24/2021] [Indexed: 12/20/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory disease of the skin with a predilection for women. The role of sex hormones, including estrogen and progesterone, is incompletely understood, but alterations in hormone levels may play a role in disease activity for many patients. Specific clinical considerations should be made for women with HS, particularly in the setting of pregnancy, childbirth, breastfeeding, and menopause. Current knowledge gaps regarding HS include the cumulative impact of disease across an individual's lifespan, as well as the mechanistic role of sex hormones in the disease. An improved understanding of the pathophysiologic role of hormones in HS would optimize our ability to use targeted therapies for hormonally driven disease. Psychological and psychosexual support for women with HS is an important facet of any holistic management strategy for the disease. This article integrates up-to-date pathogenic and mechanistic insights with evidence-based clinical management to optimize care for women with HS.
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Affiliation(s)
- Emily K. Kozera
- Liverpool Hospital Department of Dermatology, Sydney, Australia
| | | | - Jennifer L. Hsiao
- Division of Dermatology, University of California, Los Angeles, California
| | - John W. Frew
- Liverpool Hospital Department of Dermatology, Sydney, Australia
- University of New South Wales, Sydney, Australia
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11
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Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Lozano-Lozano M, Rodenas-Herranz T, Ruiz-Villaverde R. Sexual Dysfunction and Atopic Dermatitis: A Systematic Review. Life (Basel) 2021; 11:life11121314. [PMID: 34947845 PMCID: PMC8708093 DOI: 10.3390/life11121314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease of the skin whose main symptom is pruritus and may affect all age ranges. Regarding the prevalence, it has been estimated at around 10% of the world population. Many concomitant diseases have been associated with AD, but the causal relationship between AD and psychological impairment has not been clearly established. Scientific literature studying the probable association between male or female sexual dysfunction and dermatological pathology is limited, even more so in AD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the Cochrane Collaboration methodology for systematic reviews. All relevant articles in English were identified through a search from inception to 10 December 2020, including the following databases: Medline (via PubMed), Scopus, Web of Science Core Collection, and SciELO. The results of the search were compiled using the COVIDENCE software for systematic reviews. The methodological quality of the included studies was done using the “Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies” and the “Quality Assessment of Case-Control Studies” developed by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH). Our search yielded potentially relevant studies. Five studies that evaluated the prevalence of sexual dysfunction in atopic dermatitis were retrieved after applying the selection criteria. The present systematic review achieved data from 8088 patients with atopic dermatitis from four articles. Sample sizes for atopic dermatitis patients ranged from 266 to 3997. We identified one cohort study with four years of follow-up, three studies with a cross-sectional design, and one case-control study. Three studies reported data disaggregated by the severity of atopic dermatitis. Two studies included healthy controls with a total sample size of 1,747,755 subjects. Two studies compared data with other dermatological conditions such as psoriasis. In conclusion, we can establish that unlike other psychological comorbidities such as anxiety and depression, sexual dysfunction is a field scarcely explored in the literature. This sexual dysfunction focuses on the male sex in large population studies and in clinical diagnoses without exploring it through specific and validated questionnaires in this regard. Further studies focused on both genders are needed. It is important to correlate this sexual dysfunction with the severity of the disease, previous treatments, and cardiovascular comorbidities.
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Affiliation(s)
- Laura Linares-Gonzalez
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Correspondence:
| | - Ignacio Lozano-Lozano
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
| | - Luis Gutierrez-Rojas
- Department of Psychiatry, University of Granada, 18011 Granada, Spain;
- Psychiatry Service, Hospital Clínico San Cecilio, 18016 Granada, Spain
- CTS-549 Research Group, Institute of Neuroscience, University of Granada, 18016 Granada, Spain
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18011 Granada, Spain
- Sport and Health Joint University Institute (iMUDS), University of Granada, 18011 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18011 Granada, Spain
| | - Teresa Rodenas-Herranz
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
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12
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Chu CB, Yang CC, Tsai SJ. Hidradenitis suppurativa: Disease pathophysiology and sex hormones. CHINESE J PHYSIOL 2021; 64:257-265. [PMID: 34975118 DOI: 10.4103/cjp.cjp_67_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Hidradenitis suppurativa is a cutaneous chronic inflammatory disease that is estimated to affect about 1% of the population and caused pain, malodorous discharge, disfigurement, and poor quality of life with psychosocial problems. The typical features are recurrent painful nodules, abscesses, and sinus tracts on the axillae, groins, gluteal areas, and anogenital regions since postpuberty. Smoking and obesity are two major triggering factors of hidradenitis suppurativa. Women are prone to have hidradenitis suppurativa than men in Western countries, but the male-to-female ratio is reversed in oriental countries. The disease severity can be affected by menstruation, pregnancy, and menopause. Furthermore, the phenotypes are different among men and women with hidradenitis suppurativa. Men are prone to have buttock involvement while women are prone to have axillary, groins, and submammary lesions. This review introduces the skin appendages and pathophysiology of hidradenitis suppurativa and then focuses on the sex difference and the effects of sex hormones on hidradenitis suppurativa and current hormone-associated treatments.
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Affiliation(s)
- Chia-Bao Chu
- Department of Dermatology, National Cheng Kung University Hospital; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Chun Yang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine; International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan
| | - Shaw-Jenq Tsai
- Institute of Basic Medical Sciences, College of Medicine; Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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13
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Kirsten N, Frings V, Nikolakis GD, Presser D, Goebeler M, Zouboulis CC, Augustin M. [Epidemiology, patient quality of life, and treatment costs of hidradenitis suppurativa/acne inversa]. Hautarzt 2021; 72:651-657. [PMID: 34223939 DOI: 10.1007/s00105-021-04851-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
Hidradenitis suppurativa/acne inversa (HS) is associated with numerous and relevant restrictions on the quality of life for those affected and their relatives. The exact prevalence of HS varies significantly across studies, but it is likely to be higher than suggested in previous publications. HS care is associated with high costs for the healthcare system and for those affected. The introduction of biologic therapy has led to additional costs, but also to considerable additional benefits in terms of care. In view of the complexity of diagnostics and therapy, there is a particular need for optimized care concepts in order to reduce the burden on those affected, their relatives and the healthcare system.
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Affiliation(s)
- N Kirsten
- Institut für Versorgungforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Gebäude West 38 (W38), Martinistr. 52, 20246, Hamburg, Deutschland. .,Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.
| | - V Frings
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - G D Nikolakis
- Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.,Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland
| | - D Presser
- Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.,Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Goebeler
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - C C Zouboulis
- Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.,Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland
| | - M Augustin
- Institut für Versorgungforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Gebäude West 38 (W38), Martinistr. 52, 20246, Hamburg, Deutschland.,Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland
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14
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The Burden of Hidradenitis Suppurativa Signs and Symptoms in Quality of Life: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136709. [PMID: 34206415 PMCID: PMC8293810 DOI: 10.3390/ijerph18136709] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022]
Abstract
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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15
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Montero-Vilchez T, Salvador-Rodriguez L, Rodriguez-Tejero A, Sanchez-Diaz M, Arias-Santiago S, Molina-Leyva A. Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications. Life (Basel) 2021; 11:life11040277. [PMID: 33810294 PMCID: PMC8066603 DOI: 10.3390/life11040277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022] Open
Abstract
There are scarce data available regarding the impact of hidradenitis suppurativa (HS) on fertility, course and outcome of pregnancy and risk associated with treatments. The aims of this study are (1) to describe the clinical profile of HS women of childbearing age with and without accomplished reproductive desires and (2) to describe the prescribed treatments based on the fulfillment of reproductive intentions. We conducted a prospective observational study that included 104 HS women of childbearing age, 50.96% (53/104) with unfulfilled reproductive desires. These women were younger (29.08 vs. 42.06 years, p < 0.001), less frequently married and higher educated than women with fulfilled reproductive desires. Their age of disease onset was lower, but disease duration was shorter, in concordance with a lower International Hidradenitis Suppurativa Severity Score System (IHS4) and lower number of draining tunnels. Combined oral contraceptives were more frequently prescribed in women with unfulfilled reproductive desires (30.19% vs. 9.80%, p = 0.013) while biologics were less used in this group (3.77% vs. 13.73%, p = 0.08). In conclusion, a higher educational level and an earlier disease onset, with potential implications in finding a partner, may make the fulfillment of reproductive desires difficult for patients with HS. This study could help clinicians to achieve a better understanding of the specific characteristics of HS during childbearing age and consider reproductive desires when making treatment decisions.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (L.S.-R.); (A.R.-T.); (M.S.-D.); (A.M.-L.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
| | - Luis Salvador-Rodriguez
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (L.S.-R.); (A.R.-T.); (M.S.-D.); (A.M.-L.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
| | - Andrea Rodriguez-Tejero
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (L.S.-R.); (A.R.-T.); (M.S.-D.); (A.M.-L.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
| | - Manuel Sanchez-Diaz
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (L.S.-R.); (A.R.-T.); (M.S.-D.); (A.M.-L.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
| | - Salvador Arias-Santiago
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (L.S.-R.); (A.R.-T.); (M.S.-D.); (A.M.-L.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain
- Correspondence: ; Tel.: +34-9580-23422
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain; (T.M.-V.); (L.S.-R.); (A.R.-T.); (M.S.-D.); (A.M.-L.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain
- European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany
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16
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Krajewski PK, Matusiak Ł, von Stebut E, Schultheis M, Kirschner U, Nikolakis G, Szepietowski JC. Quality-of-Life Impairment among Patients with Hidradenitis Suppurativa: A Cross-Sectional Study of 1795 Patients. Life (Basel) 2021; 11:34. [PMID: 33429896 PMCID: PMC7828046 DOI: 10.3390/life11010034] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
The chronic, inflammatory skin disorder hidradenitis suppurativa (HS) is associated well documented negative influences on patients' quality of life (QoL). The aim of this study was to present more robust data on patients' QoL impairment by demographic data and its correlation with well-known HS risk factors on a cohort of 1795 German patients. The instrument used for measuring QoL in this study was the Dermatology Life Quality Index (DLQI). Overall, patients reported a very large effect of HS on their QoL (mean DLQI: 13.2 ± 8.1 points), and 22% of the analyzed population even reported to consider the effect as extremely large. Women tended to experience significantly higher impairment than men (p < 0.001). QoL impairment correlated positively with pain (r = 0.581, p < 0.001), HS severity (measured by the International Hidradenitis Suppurativa Severity Score System (IHS4)) as well as Hurley. Neck involvement tended to decrease QoL significantly more than any other location (14.7 ± 8.3 points). This study confirms the enormous influence of HS on patients' QoL in a large cohort. Knowledge of QoL impairment in such patients is crucial for proper understanding and holistic management of this disease.
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Affiliation(s)
- Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (Ł.M.)
| | - Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (Ł.M.)
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, 50923 Cologne, Germany;
| | - Michael Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Uwe Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, 55116 Mainz, Germany;
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, 06847 Dessau, Germany;
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (Ł.M.)
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17
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Sexuality in Patients with Hidradenitis Suppurativa: Beliefs, Behaviors and Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238808. [PMID: 33260862 PMCID: PMC7730576 DOI: 10.3390/ijerph17238808] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/20/2022]
Abstract
Little is known about the impact of hidradenitis suppurativa (HS) on patients’ sexuality. The aim of this research is to investigate the impact of HS on several previously unexplored aspects of sexuality. In March 2018, we conducted a crowd-sourced cross-sectional online survey hosted by the Spanish association of patients with HS (ASENDHI) and available in Spanish. A panel of experts and patients from ASENDHI designed various questions in order to explore the extent to which HS influenced participants’ sex lives. The final sample consisted of 386 participants, 79.27% (306/386) of which were women and 20.73% (80/306) of which were men. Seventy-seven point one percent (236/306) of women and 67.5% (54/80) of men were in stable relationships; the rest of the participants were single. Forty-seven point nine percent (185/386) admitted to feeling fear of rejection. Pain was the symptom that most interfered with sexual relations in women and suppuration in men. Forty-four point three percent (171/386) of the participants considered themselves to be less attractive than average. Considering the participants in a stable relationship, women described receiving more emotional support from their partners, while men received more help with lesion dressing in intimate areas. Seventy-one point four percent (207/290) of participants stated that HS negatively affected their relationship. Among single patients, women experienced greater fear of rejection and were less willing to meet new people because of HS. Ninety-four point three percent (66/70) of women and 80.8% (21/26) of men stated that HS had a negative influence on their chances of having a relationship or sexual relations. In conclusion, HS has a significant, unrecognized and misunderstood impact on sexuality which must be addressed.
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18
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Yee D, Collier EK, Atluri S, Jaros J, Shi VY, Hsiao JL. Gender differences in sexual health impairment in hidradenitis suppurativa: A systematic review. Int J Womens Dermatol 2020; 7:259-264. [PMID: 34222580 PMCID: PMC8243154 DOI: 10.1016/j.ijwd.2020.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/13/2020] [Accepted: 10/23/2020] [Indexed: 01/01/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by painful nodules, sinus tracts, and scarring, with a predilection for intertriginous areas. HS is particularly prevalent in women of childbearing age and can have varying psychological and physical consequences. The chronic and debilitating nature of this disease can lead to significant impairments in patients' sexual health and overall quality of life. This systematic review examines gender differences in the impact of HS on sexual health. In addition, we review gaps in the management of sexual health for patients with HS and outline recommendations to adequately address sexual concerns and optimize care.
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Affiliation(s)
- Danielle Yee
- University of California, Los Angeles-Olive View, Sylmar, CA, United States
| | - Erin K Collier
- David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Swetha Atluri
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Joanna Jaros
- Department of Dermatology, Cook County Hospital and Health System, Chicago, IL, United States
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jennifer L Hsiao
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
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19
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Cuenca‐Barrales C, Salvador‐Rodríguez L, Arias‐Santiago S, Molina‐Leyva A. Pre‐operative ultrasound planning in the surgical management of patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 34:2362-2367. [DOI: 10.1111/jdv.16435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/16/2020] [Indexed: 12/12/2022]
Affiliation(s)
| | - L. Salvador‐Rodríguez
- Instituto de Investigación BiosanitariaIbs Granada Granada Spain
- Hidradenitis Suppurativa Clinic Dermatology Department Hospital Universitario Virgen de las Nieves Granada Spain
| | - S. Arias‐Santiago
- Instituto de Investigación BiosanitariaIbs Granada Granada Spain
- Hidradenitis Suppurativa Clinic Dermatology Department Hospital Universitario Virgen de las Nieves Granada Spain
- Dermatology Department School of Medicine Granada University Granada Spain
| | - A. Molina‐Leyva
- Instituto de Investigación BiosanitariaIbs Granada Granada Spain
- Hidradenitis Suppurativa Clinic Dermatology Department Hospital Universitario Virgen de las Nieves Granada Spain
- European Hidradenitis Suppurativa Foundation (EHSF) Dessau‐Roßlau Germany
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20
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Cuenca‐Barrales C, Montero‐Vílchez T, Szepietowski J, Matusiak L, Molina‐Leyva A. Sexual impairment in patients with hidradenitis suppurativa: a systematic review. J Eur Acad Dermatol Venereol 2020; 35:345-352. [DOI: 10.1111/jdv.16726] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022]
Affiliation(s)
| | - T. Montero‐Vílchez
- Instituto de Investigación Biosanitaria Granada Granada Spain
- Department of Dermatology and Venereology Hidradenitis Suppurativa ClinicHospital Universitario Virgen de las Nieves Granada Spain
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - L. Matusiak
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - A. Molina‐Leyva
- Instituto de Investigación Biosanitaria Granada Granada Spain
- Department of Dermatology and Venereology Hidradenitis Suppurativa ClinicHospital Universitario Virgen de las Nieves Granada Spain
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Szepietowski JC, Matusiak Ł. Hidradenitis Suppurativa: The Disease Which Stimulates Researchers and Clinicians. Dermatology 2020; 236:5-7. [PMID: 31955165 DOI: 10.1159/000505542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jacek C Szepietowski
- Department of Dermatology, Venereology, and Allergology, Wroclaw Medical University, Wroclaw, Poland,
| | - Łukasz Matusiak
- Department of Dermatology, Venereology, and Allergology, Wroclaw Medical University, Wroclaw, Poland
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