Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.
Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
J Eur Acad Dermatol Venereol. 2019 Jun;33(6):1164-1171. doi: 10.1111/jdv.15353. Epub 2019 Apr 1.
Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes.
The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG.
Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments.
Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved.
CO laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.
化脓性汗腺炎（HS）极大地影响了与健康相关的生活质量结果。大多数治疗选择都缺乏高质量的证据支持，且没有经过验证的结果。
本研究旨在使用 HISREG 中登记的医生和患者报告的结果来评估手术和药物干预的疗效。
从 2013 年 1 月至 2016 年 4 月期间在 HISREG 中登记的所有成年患者中提取数据。主要终点包括皮肤病生活质量指数（DLQI）评分、使用数字评分量表（NRS）测量的疼痛、Sartorius 评分和 Hurley 分类。分析了 DLQI 和 NRS 疼痛的最小临床重要差异（MCID）。次要终点包括不同治疗组之间的比较、各种治疗的安全性和并发症。
本研究共纳入 255 例患者：31、188 和 36 例患者分别患有 Hurley Ⅰ期、Ⅱ期和Ⅲ期疾病。CO 激光治疗是最常见的治疗方式。149 例（58.4%）患者接受手术治疗，87 例（34.1%）接受抗生素和/或抗炎治疗，19 例（7.5%）接受手术和药物联合治疗。没有患者接受生物治疗。接受手术治疗的患者，Sartorius 评分与基线相比显著改善（P=0.001），83 例（55%）患者达到 DLQI MCID，75 例（49.7%）患者达到 NRS 疼痛 MCID。接受药物治疗的患者，Sartorius 评分与基线相比无显著改善（P=0.582）；25 例（28%）患者达到 DLQI MCID，28 例（31%）患者达到 NRS 疼痛 MCID。接受手术和药物联合治疗的患者中，9 例（48%）达到 DLQI 和 NRS 疼痛 MCID，且 Sartorius 评分显著改善。
在基于医生和患者得出的结果的分析中，CO 激光治疗比非生物药物治疗更有效。本研究为化脓性汗腺炎患者的药物和手术联合治疗提供了有限的证据。
