From the Guidelines
Hidradenitis Suppurativa (HS) has a significant impact on quality of life, causing severe pain, pruritus, chronic discharge, and persistent malodour, leading to a moderate to severe effect on quality of life, as demonstrated by an average Dermatology Life Quality Index (DLQI) score of 89 1.
Effects of HS
- Pain: HS can cause severe pain, which can be measured using a visual analogue scale or numeric rating scale (0–10) 1
- Skin symptoms: The condition can present with comedones, papules, pustules, nodules, cysts, abscesses, sinus tracts, and fistulae in flexural areas, leading to chronic discharge and malodour 1
- Scarring and mobility: Long-standing disease can result in fibrosis, dermal contractures, scarring, and a consequent reduction in mobility 1
- Complications: Disease complications include fistula formation, lymphoedema, anaemia, and the development of squamous cell carcinoma 1
Disease Severity
The Hurley staging system is used to measure baseline disease severity, and other instruments such as the HiSCR (Hidradenitis Suppurativa Clinical Response) are used to measure the efficacy of treatment, defined as a 50% reduction from baseline in inflammatory nodules and abscesses, with no increase in abscesses or draining sinuses 1.
From the Research
Effects of Hidradenitis Suppurativa (HS)
The effects of Hidradenitis Suppurativa (HS) can be severe and far-reaching, impacting not only the skin but also the patient's overall quality of life. Some of the key effects of HS include:
- Chronic pain and discomfort due to the formation of painful nodules, abscesses, and sinus tracts 2, 3, 4
- Irreversible tissue destruction and scarring, leading to morbid scarring and tunnel formation 2, 4
- Systemic comorbidities, such as metabolic and cardiovascular disorders, which can contribute to reduced life expectancy 2, 4
- Negative impact on mental health, including social withdrawal, unemployment, depression, and suicidal thoughts 2, 5
- Reduced quality of life, with patients often experiencing significant emotional and psychological distress 2, 3, 5
Physical Effects
The physical effects of HS can be debilitating, with patients experiencing:
- Painful nodules, abscesses, and sinus tracts in the axillary, inguinal, gluteal, and perianal areas 2, 3, 4
- Pus discharge and foul odor, leading to social embarrassment and isolation 3, 4
- Skin changes, including comedones, papules, and scarring, which can be permanent 6, 4
Systemic Effects
HS can also have systemic effects, including: