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Factors affecting quality of life in patients with hidradenitis suppurativa

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Abstract

Hidradenitis suppurativa (HS) has a substantial impact on patients’ lives. We identified factors associated with decreased quality of life (QoL) in patients with HS. Consecutive newly referred patients with HS attending a tertiary referral centre for HS were evaluated with the dermatology life quality index (DLQI). Clinical evaluation was performed according to the Hurley stage. Furthermore, disease duration, number of boils in the past month, boil-associated pain score, overall disease-related distress score, smoking status, employment status and comorbidities were recorded. A total of 339 patients with a mean age of 39.4 years were included; 218 (64.3%) females and 121 (35.7%) males. Of these, 96 (28.3%) had Hurley stage I, whereas 195 (57.5%) and 48 (14.2%) had Hurley II and III, respectively. The mean BMI was 29.0 (SD 7.1) kg/m2 and 75.2% of patients were current or former smokers. The mean overall DLQI score was 11.9 (SD 7.6). After mutual adjustment for clinical characteristics a significant difference in mean overall DLQI score was observed between severity groups (8.6 vs. 12.6 vs. 16.1, adjusted p < 0.001, for Hurley I, II and III, respectively), age group (12.1 vs. 12.1 vs. 12.5 vs. 7.1, adjusted p = 0.002, for ≤ 20, 21–40, 41–60 and > 60 years, respectively), employment status (11.0 vs. 14.6, adjusted p = 0.003, for employed and unemployed, respectively), presence of boils in the preceding month (8.3 vs. 13.6, adjusted p = 0.001, for no boils and presence of boils, respectively), higher overall disease-related distress score (6.3 vs. 13.9, adjusted p < 0.001, for low and high score, respectively), involvement of the groins (8.7 vs. 13.0, adjusted p = 0.035 for no and involvement, respectively), high number of anatomical regions involved (9.8 vs. 12.4 vs. 14.5, adjusted p = 0.007 for 0–1, 2 and ≥ 3 anatomical regions involved, respectively) and diabetes (11.5 vs. 15.2, adjusted p = 0.043, for no and diabetes, respectively). All ten individual DLQI question scores increased significantly with increasing Hurley stage. Patients with HS referred for specialized hospital care report substantial impact on the quality of life. Disease severity (Hurley stage), younger age, diabetes, recent and increasing disease activity and specific anogenital localization are major aggravating factors.

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Abbreviations

HS:

Hidradenitis suppurativa

BMI:

Body mass index

QoL:

Quality of life

DLQI:

Dermatology life quality index

VAS:

Visual Analog Scale

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Acknowledgements

Astrid-Helene Ravn Jørgensen had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark

    Astrid-Helene Ravn Jørgensen, Jesper Grønlund Holm, Misbah Noshela Ghazanfar, Yiqiu Yao, Hans Christian Ring & Simon Francis Thomsen

  2. Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark

    Simon Francis Thomsen

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  1. Astrid-Helene Ravn Jørgensen
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  2. Jesper Grønlund Holm
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Jørgensen, AH.R., Holm, J.G., Ghazanfar, M.N. et al. Factors affecting quality of life in patients with hidradenitis suppurativa. Arch Dermatol Res 312, 427–436 (2020). https://doi.org/10.1007/s00403-019-02025-5

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  • DOI: https://doi.org/10.1007/s00403-019-02025-5

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