Deckers, I. (Inge) (2013) A Retrospective Study on the Clinical Course of Hidradenitis Suppurativa. thesis, Medicine.
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Abstract
Background: Hidradenitis suppurativa (HS) is a chronic skin disease, characterised by inflammatory boils mostly located at inverse body areas. The disease usually develops after puberty and the prevalence seems to diminish over time. Multiple factors are associated with the onset of HS, but their influences on the clinical course are unknown. In addition, little is known about the clinical course itself. The primary aim of this study was to determine the percentage of patients who still suffer from HS, 20 to 30 years after the diagnosis was made by a dermatologist. The secondary aim was to determine factors that influenced or could predict the disease course. Methods: We conducted a questionnaire-based survey with a retrospective cohort design. A Dutch version of a validated HS-specific questionnaire was sent to a total of 79 patients who were diagnosed with HS between 1980 and 1995. In this questionnaire patients were asked if they had inflammatory lesions typical of HS in the past six months at specific body areas. In the second part they were asked in more detail about their disease and about factors that may have been of influence on the disease course. Results: In total 63 of the 79 HS patients (80%) returned the questionnaire (58 women, 5 men). Of these, 40 patients (63%) responded that they had HS (inflamed) lesions in the past six months of whom 25 patients had three or more inflammations. The mean current age of patients with active disease was significantly lower than the age of disease-free patients (53.4 vs. 58.5 years p = 0.02), also the median age of disease onset was significantly lower (18.0 vs. 28.0 years, p = 0.01). When the patients were split up in groups according to their age, the percentage of patients with active disease diminished with increasing age. Ten of the 21 patients (47%) who were 60 years or older had active HS. When comparing active disease patients and disease-free patients, patients with active disease were significantly more often affected at multiple body areas, than the disease-free patients (p = 0.03). In the same comparison, there were no differences in prior treatments (p = 0.26), smoking status (p = 0.89), median BMI (p = 0.14), or in percentage of postmenopausal women (p = 0.13). Conclusion: This study confirms the chronic character of HS, since almost two-thirds of the patients still had active disease after a median of 26 years since initial diagnosis. Even though the percentage of patients with active disease diminished with increasing age, almost half of the patients older than 60 years suffered from boils. In contrast to former belief, going through menopause did not seem to be of influence on the disease course. Lower age of onset and being affected at multiple affected body areas are possible predictors of a long disease duration. Furthermore, there were no differences in received treatments, nor in smoking habits or in body mass index between active disease and disease-free patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Boer, dr. J. |
| Supervisor name: | Prens, prof. dr. E.P. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:07 |
| Last Modified: | 25 Jun 2020 11:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2684 |
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