Hidradenitis suppurativa: Evaluating activity patterns and predictors of recalcitrant course–A population‐based study. (4th May 2022)

• Record Type: Journal Article
• Authors: Fisher, Shani; Kagan, Ilya; Zoller, Lilach; Cohen, Arnon D.; Kridin, Khalaf
• Is Part Of: Australasian journal of dermatology. Volume 63:Number 3(2022)
• Page Start: 321
• Page End: 327
• Publication Date: 2022-05-04
• Subjects: activity patterns -- hidradenitis suppurativa -- recalcitrant course; Dermatology -- Periodicals; Dermatology -- Australasia -- Periodicals; 616.5005
• DOI: 10.1111/ajd.13854
• Languages: English
• ISSNs: 0004-8380

Abstract

Abstract: Background: Epidemiological evidence regarding the course and activity patterns of hidradenitis suppurativa (HS) is yet to be delineated. Objective: To identify activity patterns of HS throughout the time axis and to outline predictors of recalcitrant disease course. Methods: A population‐based retrospective cohort study was performed to follow patients with HS ( n = 4417) throughout the initial 10 years following their diagnosis. The disease was considered active in a certain month if one of the following criteria was fulfilled: (i) purchase of an HS‐related drug, (ii) admission to a dermatological ward and (iii) referral to a dermatological consultation in an emergency room. Patients with a recalcitrant disease were defined as those with ≥5 years of follow‐up with ≥6 'active months' each. Patients with an indolent course were defined as those experiencing ≥9 years of follow‐up with ≤1 'active months' each. Results: The average (SD) number of months in which patients had an active disease was 1.37 (1.28) months per year. While 98 (2.2%) patients pursued a recalcitrant course, 1390 (31.5%) went through an indolent disease course. Older age (≥38 years; adjusted OR, 6.17; 95% CI, 3.33–11.43), Arab ethnicity (adjusted OR, 2.04; 95% CI, 1.20–3.48), low socioeconomic status (adjusted OR, 1.64; 95% CI, 1.03–2.60), obesity (adjusted OR, 3.47; 95% CI, 2.25–5.34) and smoking (adjusted OR, 2.65; 95% CI, 1.57–4.47) were found to independently predict recalcitrant course of HS. Conclusions: Mild course is more frequently encountered than severe course among Israeli patients with HS. Modifiable risk factors of recalcitrant course should be carefully addressed.