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Richards E, Joshi A. Psychosocial effects of hidradenitis suppurativa in the literature: A systematic review. Int J Psychiatry Med 2024:912174241249215. [PMID: 38644350 DOI: 10.1177/00912174241249215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Hidradenitis suppurativa (HS) is an inflammatory disorder characterized by painful, deep follicular nodules, abscesses, sinus tracts, and scarring, most commonly presenting in the inguinal, axillary, and anogenital regions. This condition substantially decreases quality of life in affected individuals, resulting in higher rates of psychiatric disorders including depression, anxiety, suicidality, and substance use. The detrimental effects of HS are well documented by dermatologists, as individuals with HS make up a large proportion of the patients that they see daily. However, it is unclear whether psychiatrists are aware of the degree of psychosocial impairment present in HS patients. It is important that those in the field of psychiatry and behavioral medicine are aware of this condition and are comfortable managing it from a psychosocial perspective. This systematic review chronicles the existing literature on the psychosocial effects of HS and assesses the extent to which dermatology journals review these effects in comparison to psychiatry or behavioral medicine.
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Affiliation(s)
| | - Ami Joshi
- Cooper Medical School of Rowan University, Camden, NJ, USA
- Cooper University Healthcare, Camden, NJ, USA
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Radhakrishna U, Ratnamala U, Jhala DD, Uppala LV, Vedangi A, Saiyed N, Patel M, Vadsaria N, Shah SR, Rawal RM, Mercuri SR, McGonagle D, Jemec GBE, Damiani G. Hidradenitis suppurativa associated telomere-methylome dysregulations in blood. J Eur Acad Dermatol Venereol 2024; 38:393-403. [PMID: 37872100 DOI: 10.1111/jdv.19586] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/03/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic debilitating disease with a significant burden of both organic and psychological comorbidities. It has been shown that certain telomere-related genes (TRGs) affect a wide range of diseases, including HS and its associated comorbidities, but their exact role in HS pathogenesis is still unknown. OBJECTIVES To determine whether TRG methylomes can be used as biomarkers in HS. METHODS Using the Illumina HumanMethylation450 BeadChip array, we examined methylation variations associated with TRGs in HS cases and age-, sex- and ethnicity-matched healthy controls. The study utilized integrated bioinformatics statistical methods, such as a false discovery rate (FDR), the area under the receiver operating characteristic curve (AUC) and principal component analysis. RESULTS There were a total of 585 different differentially methylated CpG sites identified in 585 TRGs associated with HS (474 hypomethylated and 111 hypermethylated) (FDR p-value < 0.05). A number of these CpGs have been identified as being involved in increased pain sensitivity including EPAS1, AHR, CSNK1D, DNMT1, IKBKAP, NOS3, PLCB1 and PRDM16 genes; GABRB3 as a potential alcohol addiction marker; DDB1, NSMCE2 and HNRNPA2B1 associated with cancers. Pathway analysis identified 67 statistically significant pathways, including DNA repair, telomere maintenance, mismatch repair and cell cycle control (p < 0.001). CONCLUSION The disruption of TRGs leads to the shortening of telomeres, which is associated with HS progression, ageing, cellular senescence and an increased risk of various diseases, including cancer and associated comorbidities, such as metabolic syndrome, cardiovascular disease and inflammatory disorders. Further research is necessary to better understand the underlying mechanisms and establish causal links between TRGs and HS. The present study is the first effort to comprehend potential pathomechanisms of sporadic HS cases concentrating on PBMC methylome since ours.
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Affiliation(s)
- Uppala Radhakrishna
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Uppala Ratnamala
- Department of Life Sciences, School of Sciences, Gujarat University, Ahmedabad, India
| | | | - Lavanya V Uppala
- College of Information Science & Technology, Peter Kiewit Institute, the University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Aaren Vedangi
- Department of Clinical Research, KIMS ICON Hospital, A Unit of ICON Krishi Institute Medical Sciences, Visakhapatnam, India
| | - Nazia Saiyed
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | | | | | - Sushma R Shah
- Department of Obstetrics and Gynecology, BJ Medical College Institute of Medical Post-Graduate Studies and Research, Ahmedabad, India
| | - Rakesh M Rawal
- Department of Life Sciences, School of Sciences, Gujarat University, Ahmedabad, India
| | - Santo R Mercuri
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milano, Italy
| | - Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Giovanni Damiani
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milano, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Italian Center of Precision Medicine and Chronic Inflammation, University of Milan, Milan, Italy
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Shojaei D, Liu C, Lam J. The presentation of anxiety and depression among children and youth diagnosed with hidradenitis suppurativa: A review. Pediatr Dermatol 2023; 40:983-989. [PMID: 37817294 DOI: 10.1111/pde.15434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/08/2023] [Indexed: 10/12/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with painful lesions in friction-prone areas, impacting patients' physical and mental well-being. Adults with HS experience higher rates of depression, anxiety, and reduced quality of life. Children with HS may also face these challenges, but a comprehensive review of their mental health implications is lacking. A narrative review was conducted using PubMed and Ovid Medline databases to investigate the association between HS and anxiety or depression in pediatric populations. A total of 4498 pediatric patients from six studies were included in this study: six examined depression alone, and three also studied anxiety. Two studies found a significant correlation between HS and depression in pediatric patients (p < .001), while two reported statistical significance for anxiety (p < .001). Two studies comparing pediatric and adult populations also reported a higher prevalence and incidence of depression among pediatric populations (p < .05). Another study found no incidences of depression or anxiety in HS or control patients. Despite heterogeneity in control groups, methodologies, and health system databases, the included studies suggest that pediatric patients with HS have a higher likelihood of developing depression compared to healthy pediatric patients and exhibit higher depression rates and lower anxiety rates compared to adults. These findings and the limited availability of data regarding this topic underscore the imperative for increased screening, evaluation, and reporting of psychiatric disorders among pediatric populations. This can help understand the connection between HS and depression or anxiety and ultimately enhance the mental well-being and quality of life for affected children.
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Affiliation(s)
- Delaram Shojaei
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chaocheng Liu
- Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph Lam
- Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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Towfighi P, Huffman SS, Bovill JD, Shan HD, Haffner ZK, Kim EY, Slamin R, Benedict CD, Evans KK. Financial toxicity of hidradenitis suppurativa: A single-center experience at an urban wound-care clinic. J Dermatol 2023; 50:1279-1286. [PMID: 37501527 DOI: 10.1111/1346-8138.16868] [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: 03/23/2023] [Revised: 05/12/2023] [Accepted: 06/08/2023] [Indexed: 07/29/2023]
Abstract
Hidradenitis suppurativa (HS), is a chronic inflammatory skin disorder that confers a substantial financial burden to patients. The aim of the current study was to assess the patient-reported financial impact of HS. Patients presenting to a wound center between 2010 and 2021 were retrospectively reviewed. Demographics, comorbidities, and disease characteristics were collected. The financial impact of HS was assessed via the Comprehensive Score for Financial Toxicity - Functional Assessment of Chronic Illness Therapy (COST-FACIT) version 2 and investigator-generated surveys. Of 199 patients contacted, 27.1% (n = 54) completed the survey. The majority were women (77.8%, n = 42) and had private health insurance (n = 30; 55.6%). Most patients (66.7%, n = 36) had Hurley stage III disease. Mean follow-up was 2.3 + 2.8 years. The overall COST score was 19.7 + 12.4, indicating grade 1 financial toxicity (FT). Grade 0 FT was reported in 31.5% (n = 17) of patients, grade 1 in 37.0% (n = 20), grade 2 in 27.8% (n = 15), and grade 3 in 3.7% (n = 2). The mean self-reported 12-month out-of-pocket cost and credit scores were $2250 + 3269.24 and 674.6 + 95.3, respectively. Patients with private insurance had lower FT compared with Medicaid and Medicare (p = 0.003). Higher out-of-pocket costs were positively correlated with FT (p = 0.042), while higher credit scores were negatively correlated (p = 0.003). Patients with HS lesions in three or more anatomic regions reported the highest FT (p = 0.031). HS is a debilitating skin disorder that affects the livelihood of patients in a multifaceted manner. These patient-reported outcomes highlight the impact that HS has on an individual's financial security, calling for further attention to this vulnerable population.
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Affiliation(s)
- Parhom Towfighi
- Georgetown University School of Medicine, Washington, DC, USA
| | - Samuel S Huffman
- Georgetown University School of Medicine, Washington, DC, USA
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - John D Bovill
- Georgetown University School of Medicine, Washington, DC, USA
| | - Holly D Shan
- Georgetown University School of Medicine, Washington, DC, USA
| | - Zoë K Haffner
- Georgetown University School of Medicine, Washington, DC, USA
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Emily Y Kim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Robert Slamin
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Carol D Benedict
- Department of Rheumatology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Karen K Evans
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
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Ng MSP, Lim JG, Koh JMY, Lee SY, Seah CHX, Chang SJY, Tan JTA, Tan VWS, Kumar DS, Choi ECE, Jemec G, Frew J, Seow WJ, Chandran NS. Knowledge, attitudes, and perceptions of hidradenitis suppurativa among young adults in Singapore. JAAD Int 2023; 12:72-80. [PMID: 37274383 PMCID: PMC10236457 DOI: 10.1016/j.jdin.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/06/2023] Open
Abstract
Background The prevalence of hidradenitis suppurativa (HS) is 0.00033% to 4.10% globally. Few epidemiological studies derive from Asia, with social stigmatization postulated to result in under-diagnosis. Objective This study aimed to assess the self-reported prevalence of HS, and the knowledge, attitudes, and perceptions towards HS among Singaporean young-adults. Methods A cross-sectional study (n = 158) was conducted by anonymous online questionnaire. The association between demographic factors and risk of potentially undiagnosed HS was evaluated using multivariable logistic regression. Differences between attitude-perception scores by demographic factors and knowledge of HS were tested using two-sample t-tests. Results The prevalence of diagnosed and potentially undiagnosed HS was 0.63% and 8.9%, respectively. Non-Chinese had significantly higher social attitude-perception scores than Chinese (P = .029). Females had significantly higher social (P = .048) as well as economic and work (P = .037) attitude-perception scores than males. Those with knowledge of HS had significantly higher attitude-perception scores for interpersonal (P = .031) and social (P = .0052) subsections. Limitations Small sample size, low frequency of HS cases, and self-reported prevalence may not generalize to the broader population in Singapore. Conclusion Our results suggest a potential underdiagnosis of HS. Non-Chinese stigmatize HS less than Chinese, and females less than males. Individuals with knowledge of HS might be more open to interpersonal and social interactions with HS sufferers.
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Affiliation(s)
- Matthew Song Peng Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joel Guanyi Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - John Ming Yan Koh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sz-Ying Lee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Claire Hui Xian Seah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Samuel Jun Yi Chang
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua Teik Ann Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Vanessa Wei Shen Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Dhana Senthil Kumar
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ellie Ci-En Choi
- Division of Dermatology, Department of Medicine, National University Hospital, Singapore
| | - Gregor Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - John Frew
- Department of Dermatology, Liverpool Hospital, University of New South Wales, Sydney, Australia
| | - Wei Jie Seow
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Nisha Suyien Chandran
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Dermatology, Department of Medicine, National University Hospital, Singapore
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Johnston L, Dupuis E, Lam L, Poelman S. Understanding Hurley Stage III Hidradenitis Suppurativa Patients' Experiences With Pain: A Cross-Sectional Analysis. J Cutan Med Surg 2023; 27:487-492. [PMID: 37489915 PMCID: PMC10616983 DOI: 10.1177/12034754231188452] [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: 04/08/2023] [Revised: 05/20/2023] [Accepted: 07/01/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND More than 90% of patients with hidradenitis suppurativa (HS) report that pain interferes with their quality of life (QoL) and pain may have a larger impact on QoL than disease severity alone. OBJECTIVES The purpose of this study was to understand the impact of pain on the daily lives of patients with Hurley stage III HS. METHODS This was a single-center, prospective cross-sectional study that was conducted at Beacon Dermatology in Calgary, AB. Patients ≥ 18 years old with Hurley stage III HS in at least one area of the body were prospectively invited to participate in this study. The study consisted of survey questions on patients' demographic information, past medical histories, HS-related pain histories, and previous therapies for pain management. Additionally, patients completed a series of standardized rating scales on their pain and overall QoL. RESULTS Of the 10 patients that participated in the study, 90% (9/10) expressed a desire for more counselling on pain management options. Many patients (8/10, 80%) reported routine use of over-the-counter pain medications and 70% (7/10) used complementary and alternative medicines (CAMs) to manage their pain. Patients' efficacy ratings of HS treatments in controlling their pain revealed that topical treatments provided minimal or no relief, while surgical interventions had the highest efficacy for reducing pain. Patients' average worst pain over the preceding 24 hrs was 6.3 +/- 2.5 (2-9) on the Numerical Rating Scale for pain and the mean Dermatology Life Quality Index score was 19.5 +/- 8.2 (5-29). CONCLUSIONS Patients with Hurley stage III HS report high levels of daily pain and QoL impairment and many individuals use over-the-counter treatments and CAMs to manage their pain. Physicians involved in the care of HS patients should consider implementing routine counselling on pain management into their clinical practices, especially for patients with severe HS.
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Affiliation(s)
- Leah Johnston
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Elaine Dupuis
- Cumming School of Medicine, University of Calgary, Calgary, Canada
- Beacon Dermatology, Calgary, Canada
| | - Lauren Lam
- Beacon Dermatology, Calgary, Canada
- Department of Dermatology, University of Alberta, Edmonton, Canada
| | - Susan Poelman
- Cumming School of Medicine, University of Calgary, Calgary, Canada
- Beacon Dermatology, Calgary, Canada
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Rathod U, Prasad PN, Patel BM, Patel B, Patel C, Gandhi SK, Patel P. Hidradenitis Suppurativa: A Literature Review Comparing Current Therapeutic Modalities. Cureus 2023; 15:e43695. [PMID: 37724217 PMCID: PMC10505353 DOI: 10.7759/cureus.43695] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a disease with a poor prognosis, often misinterpreted as an infection, with the highest impact on the patient's quality of life among all the assessed dermatological diseases. The main aim of this study was to compare various therapeutic interventions that are currently available for the treatment of HS. The pathogenesis of HS is not well understood, but it is mostly multifactorial involving a number of factors like genetic factors, androgens, local immunity, microflora, smoking, and obesity. Despite limited evidence on their effectiveness, topical antibiotics and antiseptics are commonly employed. Due to the colonization of bacteria and the presence of biofilms in the sinus tracts formed by HS lesions, systemic antibiotics are commonly employed as the primary form of therapy. In females with HS who experience menstrual flares or display symptoms of polycystic ovary syndrome, hormonal agents are often considered to be a viable and effective therapeutic option. At present, the sole treatment approved by both the Food and Drug Administration and the European Medicines Agency for addressing moderate to severe HS is adalimumab, an antibody that targets tumor necrosis factor alpha. Many surgical procedures in the management of HS aim to address inflammation by eliminating the affected folliculo-pilosebaceous unit, sinus tracts, and associated debris to impede further progression and scarring. HS continues to pose a considerable treatment challenge, necessitating a comprehensive approach for patients. However, the available evidence for most of these treatments is limited, indicating the need for more extensive research to identify the most effective interventions for managing HS.
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Affiliation(s)
- Urvashi Rathod
- Department of Internal Medicine, Narendra Modi Medical College, Ahmedabad, IND
| | - Pooja N Prasad
- Department of Internal Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | | | - Brinda Patel
- Department of Internal Medicine, Gujarat Medical Education and Research Society, Sola, Ahmedabad, IND
| | - Chintankumar Patel
- Department of Internal Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Siddharth Kamal Gandhi
- Department of Internal Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Priyansh Patel
- Department of Internal Medicine, Medical College Baroda, Vadodara, IND
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Orenstein LAV, Salame N, Siira MR, Urbanski M, Flowers NI, Echuri H, Garg A, McKenzie-Brown AM, Curseen KA, Patzer RE, Kavalieratos D, Chen SC. Pain experiences among those living with hidradenitis suppurativa: a qualitative study. Br J Dermatol 2023; 188:41-51. [PMID: 36689519 DOI: 10.1093/bjd/ljac018] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Pain is rated by patients with hidradenitis suppurativa (HS) as the disease's most impactful symptom. HS therapies are often insufficient to control inflammatory disease activity and pain. A better understanding of patient experiences with pain may improve patient-provider relationships and help identify strategies for addressing HS pain. OBJECTIVES This qualitative study sought to characterize lived pain experiences of those with HS. METHODS English-speaking patients ≥ 18 years old with a dermatologist-confirmed diagnosis of HS and an average numerical rating scale pain score of ≥ 1 over the preceding week were recruited from a single academic medical centre in Atlanta, Georgia, USA. Semistructured interviews were conducted from November 2019 to March 2020 to explore participants' HS pain experiences and the subsequent impact on their lives. Thematic saturation was reached after interviewing 21 participants. Interviews were audio recorded, transcribed, and analysed using thematic analysis. RESULTS Among 21 study participants, the median 7-day average pain score was 6 (interquartile range 3-7; scale ranges from 0 to 10, with 10 being most pain). Participants' descriptions of pain were consistent with nociceptive pain, neuropathic pain and itch. Pain impacted multiple life domains, including physical limitations (decreased mobility and impaired sleep), decreased psychological wellbeing (irritability, depression, loss of control, and difficulty communicating pain experiences) and impaired social relationships (social isolation, intimacy problems and difficulty fulfilling social responsibilities). Although participants reported chronic discomfort, acutely painful and unpredictable HS disease flares caused more distress and quality-of-life (QoL) burden. Participants frequently treated their pain without input from the medical team, sometimes with unsafe medication doses or combinations. Factors contributing to self-management of pain included difficulty accessing timely outpatient care during disease flares and fear of stigma from healthcare providers. CONCLUSIONS When present, HS-related pain may impact not only physical wellbeing but also mental health and relationships. In addition to therapies that target the inflammatory disease burden, treating the symptom of pain may improve patients' QoL and wellbeing. Because patients with HS have difficulty explaining their pain, proactively asking them about pain may identify unmet needs, facilitate better pain control and improve QoL. Further, the influence of HS-related pain on numerous aspects of QoL suggests the need for multidisciplinary, patient-centred approaches to HS pain management.
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Affiliation(s)
- Lauren A V Orenstein
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nicole Salame
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Meron R Siira
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Megan Urbanski
- Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, GA, USA
| | - Nyla I Flowers
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Harika Echuri
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Amit Garg
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | | | - Kimberly A Curseen
- Department of Family and Preventive Medicine, Division of Palliative Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Rachel E Patzer
- Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, GA, USA
| | - Dio Kavalieratos
- Department of Family and Preventive Medicine, Division of Palliative Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Suephy C Chen
- Department of Dermatology, Duke University School of Medicine, Durham, NC, USA
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A Practical Guide for Primary Care Providers on Timely Diagnosis and Comprehensive Care Strategies for Hidradenitis Suppurativa. Am J Med 2023; 136:42-53. [PMID: 36252715 DOI: 10.1016/j.amjmed.2022.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 12/13/2022]
Abstract
Hidradenitis suppurativa is a chronic, progressive inflammatory disease of the skin with many systemic implications. Hidradenitis suppurativa is frequently underdiagnosed or misdiagnosed, particularly because of heterogeneity in presentation and low disease recognition. Patients can see multiple types of health care providers, including primary care providers, along their journey to an accurate diagnosis. This review provides a comprehensive overview of the clinical presentation, associated comorbidities, and life impact associated with hidradenitis suppurativa. Disease features described here can facilitate earlier identification of hidradenitis suppurativa, differentiation from common mimickers, and timely referrals for multidisciplinary management when needed. Engagement of the medical community will also support comprehensive care strategies necessary in hidradenitis suppurativa.
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