Nielsen R M, Lindsø Andersen P, Sigsgaard V, Theut Riis P, Jemec G B
Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
Br J Dermatol. 2020 Jan;182(1):166-174. doi: 10.1111/bjd.17935. Epub 2019 Jul 8.
Pain is a prominent symptom of hidradenitis suppurativa (HS) and has been defined as a domain in the Core Outcome Set for the disease. Quality and intensity of pain is influenced by depression and anxiety, both of which are associated with HS.
To describe HS-related pain quantitatively and qualitatively; and to investigate how disease severity, depression and anxiety correlate with self-reported pain quality.
Pain perception was investigated using the McGill Pain Questionnaire. Symptoms of depression and anxiety were examined using the Hospital Anxiety and Depression Scale. Statistical analyses investigated differences in number of words chosen (NWC) and pain-rating index rank [PRI(R)] in patients with severe disease and in patients with depression/anxiety.
A total of 138 patients with HS were recruited in an outpatient clinic (October 2017-March 2018). Patients presented a median NWC of 11·5 and a PRI(R) of 59·0%. Most common descriptors were 'shooting' (83%), 'itchy' (79%) and 'blinding' (75%). Patients with depression or anxiety presented significantly higher PRI(R)s [depressed 65% vs. non-depressed 57% (P = 0·015); anxious 65% vs. nonanxious 57% (P = 0·004)]. Patients with involvement of three or more HS regions vs. those with fewer than three involved regions exhibited a significantly higher NWC (13 vs. 8; P = 0·048).
HS-related pain includes nociceptive and neuropathic pain, and perception appears to be influenced by disease severity, anxiety and depression. A multimodal pain management strategy may be the most appropriate; however, more detailed studies are necessary to define recommendations on pain management. What's already known about this topic? Pain is a core outcome domain hidradenitis suppurativa. Few studies have addressed this significant clinical problem. What does this study add? This study suggests that HS pain comprises both nociceptive and neuropathic pain. Pain appears associated to depression, anxiety and severity of the disease.
疼痛是化脓性汗腺炎（HS）的一个突出症状，并且已被定义为该疾病核心结局指标中的一个领域。疼痛的质量和强度受抑郁和焦虑的影响，而这两者均与HS相关。
定量和定性地描述与HS相关的疼痛；并研究疾病严重程度、抑郁和焦虑如何与自我报告的疼痛质量相关。
使用麦吉尔疼痛问卷调查疼痛感知。使用医院焦虑抑郁量表检查抑郁和焦虑症状。统计分析研究了重症患者以及伴有抑郁/焦虑的患者在所选单词数量（NWC）和疼痛评分指数排名[PRI(R)]方面的差异。
2017年10月至2018年3月期间，在一家门诊诊所招募了总共138例HS患者。患者的NWC中位数为11.5，PRI(R)为59.0%。最常见的描述词是“刺痛”（83%）、“瘙痒”（79%）和“剧痛”（75%）。伴有抑郁或焦虑的患者的PRI(R)显著更高[抑郁患者为65%，非抑郁患者为57%（P = 0.015）；焦虑患者为65%，非焦虑患者为57%（P = 0.004）]。累及三个或更多HS区域的患者与累及区域少于三个的患者相比，NWC显著更高（分别为13和8；P = 0.048）。
与HS相关的疼痛包括伤害性疼痛和神经性疼痛，并且其感知似乎受疾病严重程度、焦虑和抑郁的影响。多模式疼痛管理策略可能是最合适的；然而，需要更详细的研究来确定疼痛管理的建议。关于该主题已了解哪些内容？疼痛是化脓性汗腺炎的一个核心结局领域。很少有研究探讨这个重要的临床问题。本研究增加了什么内容？本研究表明HS疼痛包括伤害性疼痛和神经性疼痛。疼痛似乎与抑郁、焦虑和疾病严重程度相关。
