Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Dermatology. 2020;236(5):421-430. doi: 10.1159/000508787. Epub 2020 Jul 1.
Hidradenitis suppurativa (HS) is a neglected chronic inflammatory disease with long delay in diagnosis. Besides pain, purulent discharge, and destruction of skin architecture, HS patients experience metabolic, musculoskeletal, and psychological disorders.
To determine the delay in HS diagnosis and its consequences for patients and the healthcare system.
This was a prospective, multicenter, epidemiologic, non-interventional cross-sectional trial carried out in Germany and based on self-reported questionnaires and medical examinations performed by dermatologists. In total, data of 394 adult HS patients were evaluated.
The average duration from manifestation of first symptoms until HS diagnosis was 10.0 ± 9.6 (mean ± SD) years. During this time, HS patients consulted on average more than 3 different physicians - most frequently general practitioners, dermatologists, surgeons, gynecologists - and faced more than 3 misdiagnoses. Diagnosis delay was longer in younger and non-smoking patients. In most cases, HS was correctly diagnosed by dermatologists. The longer the delay of diagnosis, the greater the disease severity at diagnosis. Delayed HS diagnosis was also associated with an increased number of surgically treated sites, concomitant diseases, and days of work missed.
This study demonstrates an enormous delay in the diagnosis of HS, which results in more severe disease. It also shows for the first time that a delay in diagnosis of a chronic inflammatory disease leads to a higher number of concomitant systemic disorders. In addition to the impaired health status, delayed diagnosis of HS was associated with impairment of the professional life of affected people.
化脓性汗腺炎（HS）是一种被忽视的慢性炎症性疾病，其诊断存在较长的延误。除了疼痛、脓性分泌物和皮肤结构破坏外，HS 患者还会出现代谢、肌肉骨骼和心理障碍。
确定 HS 诊断的延迟及其对患者和医疗保健系统的影响。
这是一项在德国进行的前瞻性、多中心、基于问卷调查的、非干预性、横断面研究，同时进行了皮肤科医生进行的医学检查。共评估了 394 例成年 HS 患者的数据。
从首次出现症状到 HS 诊断的平均时间为 10.0 ± 9.6（平均值 ± 标准差）年。在此期间，HS 患者平均咨询了 3 位以上的医生，最常见的是全科医生、皮肤科医生、外科医生和妇科医生，并且经历了 3 次以上的误诊。年轻和不吸烟的患者诊断延迟时间更长。大多数情况下，HS 由皮肤科医生正确诊断。诊断延迟时间越长，诊断时疾病的严重程度越大。HS 诊断的延迟也与接受手术治疗的部位、并存疾病和缺勤天数的增加有关。
这项研究表明 HS 的诊断存在巨大的延迟，导致疾病更加严重。它还首次表明，慢性炎症性疾病诊断的延迟会导致更多的全身性合并症。除了健康状况受损外，HS 的延迟诊断还会影响受影响人群的职业生活。
