Original article
Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity

https://doi.org/10.1016/j.jaad.2009.02.013Get rights and content

Background

Factors associated with the severity of hidradenitis suppurativa (HS) are not known.

Objective

We sought to identify factors associated with the severity of HS.

Methodology

The severity of disease in a series of 302 consecutive patients with HS was assessed using the Sartorius score.

Results

Atypical locations were more common in men than in women (47.1% vs 14.8%; P < .001). Men also had more severe disease (median Sartorius score: 20.5 vs 16.5; P = .02). Increased body mass index (P < .001), atypical locations (P = .002), a personal history of severe acne (P = .04), and absence of a family history of HS (P = .06) were associated with an increased Sartorius score. The Sartorius score was highly correlated with the intensity and duration of pain and suppuration (all P values < .001).

Limitations

The referral center base of the study may have biased recruitment.

Conclusion

Our data showed a significant association between the severity of HS and several clinical and behavioral factors. Prospective studies are needed to confirm the prognostic role of these factors.

Section snippets

Patients

All consecutive patients with HS referred to our hospital from 1998 to 2006 were interviewed and examined by one of us (G.G., F.P., or F.P.) and, during their first visit, were systematically reassessed by the principal investigator (J.E.R.). Diagnostic criteria for HS were established as follows, and all 3 criteria were necessary to establish the diagnosis: (1) presence of typical lesions: deep-seated nodules (“blind boils”), abscesses, fibrosis, or a combination of these; (2) location in

Characteristics of the patients and difference between sexes

During the study period, 302 patients were included, 232 female and 70 male (female:male ratio = 3.3:1). Table III summarizes the characteristics of patients and comparisons between the sexes. The median age was 30.4 years (IQR = 12.9) at the time of evaluation and 20.0 years (IQR = 11) at the beginning of the disease. The disease seemed to begin earlier in patients with a family history of HS, the median age at the onset of the disease being 18 years (IQR = 8.5) versus 20 years (IQR = 11) (P =

Discussion

By studying a large series of patients, we were able to give a comprehensive clinical description of HS, and to determine the differences between the sexes. First, we showed that locations on the front the body were more frequent in women; the presence of acne was more frequent in men. Second, we demonstrated that the Sartorius score was strongly associated with other markers of severity, such as the frequency and intensity of pain and suppuration, and the Hurley classification. Third, a

References (19)

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Funding sources: None.

Conflicts of interest: None declared.

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