Factors Associated with Severe Hidradenitis Suppurativa, Using Hurley Staging and Metascore.

IF 3 3区医学 Q2 DERMATOLOGY Dermatology Pub Date : 2024-01-01 Epub Date: 2024-10-11 DOI:10.1159/000541052

Mathieu Daoud, Mariano Suppa, Farida Benhadou, Stéphanie Heudens, Anne-Sophie Sarkis, Hassane Njimi, Sara K Saunte, Lila Desmarest, Carmen Orte Cano, Céline Dandoy, Laura Nobile, Margot Fontaine, Mathilde Daxhelet, Jalila Karama, Jonathan M White, Gregor B E Jemec, Véronique Del Marmol

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Abstract

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease for which certain risk factors are well known: obesity and smoking (in particular). However, the factors associated with more severe conditions, and therefore potential aggravators of the disease, remain a matter of debate. Our study aims to determine the clinical factors associated with severe HS using several severity scores.

Methods: The data were obtained via the ERHS questionnaire from patients exclusively recruited at Erasme Hospital in Brussels. The severity of HS was firstly estimated by the Hurley score, and secondly by a metascore, a system combining the iHS4, HS-PGA, SAHS, and DLQI. Univariable and multivariable analyses were performed.

Results: Six hundred and forty-seven patients were included in the Hurley analysis, and 456 patients in the metascore analysis. In multivariable analysis, men have a more severe metascore than women (odds ratio [OR] = 1.89, p = 0.022), smoking was associated with a more severe disease according to metascore, especially in mild cases (OR = 0.76, p = 0.043), and an elevated body mass index was associated with having Hurley stage III disease compared to Hurley I or II disease (OR = 1.09, p = 0.001). A significant association is also shown between blood pressure and Hurley stage (OR = 0.97, p = 0.025). Self-reports of nonsteroidal anti-inflammatory drugs aggravating the disease is also a factor associated with greater severity according to the metascore (OR = 0.12, p = 0.008). Finally, several locations of HS lesions were associated with greater severity, in particular the armpits according to the metascore (OR = 0.29, p < 0.001), and the perianal area according to the Hurley score (OR = 0.15, p < 0.001).

Conclusion: HS seems to be more severe in men; smoking seems to aggravate mild cases of HS, while increased body mass index plays a major role in the transition from Hurley II to Hurley III.

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使用赫利分期法和 Metascore 测量与重度化脓性角膜炎相关的因素。

导言化脓性扁平湿疹（HS）是一种慢性炎症性皮肤病，其某些风险因素众所周知：肥胖和吸烟（尤其是）。然而，与更严重病情相关的因素，以及因此可能导致病情加重的因素，仍是一个争论不休的问题。我们的研究旨在通过几种严重程度评分来确定与严重 HS 相关的临床因素：方法：我们通过 ERHS 问卷获得了布鲁塞尔 Erasme 医院专门招募的患者的数据。HS的严重程度首先由Hurley评分估算，其次由metascore评分估算，该系统结合了iHS4、HS-PGA、SAHS和DLQI。进行了单变量和多变量分析：有 647 名患者被纳入赫利分析，456 名患者被纳入 metascore 分析。在多变量分析中，男性的 metascore 比女性更严重（比值比 [OR] = 1.89，p = 0.022），根据 metascore，吸烟与更严重的疾病相关，尤其是在轻度病例中（OR = 0.76，p = 0.043），与 Hurley I 或 II 期疾病相比，体重指数升高与 Hurley III 期疾病相关（OR = 1.09，p = 0.001）。血压与 Hurley 分期之间也存在明显关联（OR = 0.97，p = 0.025）。自我报告使用非甾体类抗炎药会加重病情，这也是根据 metascore（OR = 0.12，p = 0.008）判断病情严重程度的一个相关因素。最后，HS病变的几个部位与病情的严重程度有关，尤其是根据 metascore（OR = 0.29，p <0.001）得出的腋窝部位和根据 Hurley 评分得出的肛周部位（OR = 0.15，p <0.001）：结论：HS似乎在男性中更为严重；吸烟似乎会加重轻度HS的病情，而体重指数的增加在从Hurley II到Hurley III的转变过程中起着重要作用。

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来源期刊

Dermatology 医学-皮肤病学

CiteScore

6.40

自引率

2.90%

发文量

审稿时长

1 months

期刊介绍： Published since 1893, ''Dermatology'' provides a worldwide survey of clinical and investigative dermatology. Original papers report clinical and laboratory findings. In order to inform readers of the implications of recent research, editorials and reviews prepared by invited, internationally recognized scientists are regularly featured. In addition to original papers, the journal publishes rapid communications, short communications, and letters to ''Dermatology''. ''Dermatology'' answers the complete information needs of practitioners concerned with progress in research related to skin, clinical dermatology and therapy. The journal enjoys a high scientific reputation with a continually increasing impact factor and an equally high circulation.