Garcovich Simone, Muratori Simona, Moltrasio Chiara, Buscemi Agata Alba, Giovanardi Giulia, Malvaso Dalma, Di Stasio Enrico, Marzano Angelo Valerio, Peris Ketty
Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Dermatologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Clin Med. 2020 Dec 15;9(12):4046. doi: 10.3390/jcm9124046.
Pain is a core symptom of hidradenitis suppurativa (HS) and is of complex, multifactorial origin. HS patients frequently report typical neuropathic pain qualities, but its prevalence has been poorly described.
In this cross-sectional study, we examine the prevalence of neuropathic pain (NP) component and related pain-characteristics of a hospital-based cohort of patients with symptomatic HS. We administered the pain-DETECT tool (PDQ), a validated screening tool for NP, collecting clinical and patient-reported data on pain, pruritus and pain-management. We obtained 110 complete datasets from symptomatic HS patients (49.1% females; Hurley I (27.3%])-II (45.5%)-III (27.3%)). According to the PDQ tool, 30% of patients were classified with a high probability (>90%) of neuropathic pain (LNP). LNP status was significantly associated with increased pain severity, disease activity, pruritus intensity and use of pain medication. Regression analysis showed a significant impact of the PDQ score on patient-reported outcomes, including pain severity and the dimensions of activity and affective pain interference. HS patients may present a mixed chronic pain phenotype with a neuropathic component, thus requiring additional pain-assessments. A multi-modal approach to pain management, in combination with disease-specific treatment, should be implemented in future interventional studies.
疼痛是化脓性汗腺炎(HS)的核心症状,其起源复杂且多因素。HS患者经常报告典型的神经性疼痛特征,但其患病率描述甚少。
在这项横断面研究中,我们调查了有症状HS患者的医院队列中神经性疼痛(NP)成分的患病率及相关疼痛特征。我们使用了疼痛DETECT工具(PDQ),这是一种经过验证的NP筛查工具,收集有关疼痛、瘙痒和疼痛管理的临床及患者报告数据。我们从有症状的HS患者中获得了110个完整数据集(女性占49.1%;Hurley I期[27.3%] - II期[45.5%] - III期[27.3%])。根据PDQ工具,30%的患者被归类为神经性疼痛可能性高(>90%)(LNP)。LNP状态与疼痛严重程度增加、疾病活动、瘙痒强度及止痛药物使用显著相关。回归分析显示PDQ评分对患者报告结局有显著影响,包括疼痛严重程度以及活动和情感性疼痛干扰维度。HS患者可能呈现出具有神经性成分的混合性慢性疼痛表型,因此需要额外的疼痛评估。未来的干预研究应采用多模式疼痛管理方法并结合疾病特异性治疗。