Department of Dermatology and Venereology, Riga Stradiņš University, Riga, Latvia.
Department of Surgery, Riga 1st Hospital, Riga, Latvia.
Dermatol Ther. 2021 Jan;34(1):e14687. doi: 10.1111/dth.14687. Epub 2020 Dec 23.
Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating, and frequently misdiagnosed inflammatory skin disease that often requires surgical intervention. To assess the prevalence of HS patients in surgeons' practice and surgeons' approach to treating HS patients, we created a self-administered, Hurley stage-based questionnaire that was distributed during the Latvian Association of Surgeons meeting. Of the total 60 questionnaires distributed, 56 (93%) were collected and 53 (88%) of them were considered valid. Overall, 73.6% of the surgeons confirmed having seen patients with chronic inflamed suppurative lesions in the skin folds during their practice. Median reported number of HS patients in the surgeons' practice was 3, ranging from 0 to 30. Similarly, 73.6% of surgeons would undertake HS treatment. The proportion of surgeons undertaking treatment was higher if the surgeons had diagnosed HS by themselves but was not affected by personal knowledge of HS. Surgeons chose monotherapy for Hurley stages I, II, and III in 64.2%, 64.2%, and 62.3% of the cases, respectively. The most common therapeutic choice for monotherapy was topical antiseptics (26.4%) or topical antibiotics (20.8%) for Hurley stage I and surgery or systemic antibiotics for Hurley stage II (20.8% or 17.0%, respectively) and Hurley stage III (32.1% or 11.3%, respectively). A wide diversity of treatment approaches in specified clinical scenarios was observed, which indicates the need for local guidelines.
化脓性汗腺炎(HS)是一种慢性、复发性、使人虚弱且常被误诊的炎症性皮肤病,通常需要手术干预。为了评估外科医生实践中 HS 患者的患病率以及外科医生治疗 HS 患者的方法,我们创建了一个基于 Hurley 分期的自我管理问卷,并在拉脱维亚外科医生协会会议期间进行了分发。在总共分发的 60 份问卷中,收集到了 56 份(93%),其中 53 份(88%)被认为是有效的。总的来说,93%的外科医生在他们的实践中确认见过患有慢性炎症性化脓性皮损的患者。报告的外科医生实践中 HS 患者的中位数为 3 例,范围为 0 至 30 例。同样,73.6%的外科医生会进行 HS 治疗。如果外科医生自行诊断为 HS,则进行治疗的外科医生比例较高,但不受个人对 HS 了解程度的影响。对于 Hurley 分期 I、II 和 III,外科医生分别选择单药治疗的比例为 64.2%、64.2%和 62.3%。单药治疗的最常见治疗选择是局部防腐剂(26.4%)或局部抗生素(20.8%)用于 Hurley 分期 I,手术或全身抗生素用于 Hurley 分期 II(20.8%或 17.0%)和 Hurley 分期 III(32.1%或 11.3%)。在特定临床情况下观察到治疗方法的多样性很大,这表明需要制定当地指南。