MedWire News: The clinical presentation of hidradenitis suppurativa (HS) differs strongly in women and men, researchers report.
HS has been defined as ‘‘chronic suppuration of inverse areas characterized by recurrent, painful, deep-seated nodules and abscesses of apocrine gland-bearing skin,” say Jean Revuz (Hôpital Henri Mondor, Créteil, France) and colleagues.
They studied the clinical characteristics of the disease in 302 consecutive French patients referred to a single hospital between 1998 and 2006.
Atypical locations, such as the ear, chest, abdomen, or legs, were significantly more common in men than in women, at 47.1% versus 14.8%.
Disease severity rated according to the Sartorius score, which takes into account disease extent, and the number and severity of individual lesions, was also greater in men, at a median of 20.5 compared with 16.5 in women.
The Sartorius score correlated with the Hurley classification of intensity and duration of pain and suppuration. “These observations suggest that the Sartorius score may well reflect the severity of HS,” say the researchers.
Increased body mass index (BMI), atypical locations, and a personal history of severe acne were each independently associated with increased severity of disease in multivariate analysis.
A BMI increase of 1 kg/m2 was associated with an increase of 0.84 in mean Sartorius score, while atypical locations and a personal history of severe acne were each associated with increases of 5.60 and 3.37, respectively.
Patients with a family history of HS tended to have less severe disease, which was borderline statistically significant, and a result the researchers called “unexpected.”
Reporting in the Journal of the American Academy of Dermatology, they conclude: “The recognition of a wide spectrum of severity has an impact on the treatment of patients with HS; an exclusively surgical approach does not seem justified.”
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