Daoud Mathieu, Suppa Mariano, Benhadou Farida, Heudens Stéphanie, Sarkis Anne-Sophie, Njimi Hassane, Saunte Sara K, Desmarest Lila, Orte Cano Carmen, Dandoy Céline, Nobile Laura, Fontaine Margot, Daxhelet Mathilde, Karama Jalila, White Jonathan M, Jemec Gregor B E, Del Marmol Véronique
Dermatology, Hôpital Universitaire de Bruxelles (H.U.B.), Université Libre de Bruxelles, Brussels, Belgium.
Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
Dermatology. 2024;240(5-6):713-731. doi: 10.1159/000541052. Epub 2024 Oct 11.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease for which certain risk factors are well known: obesity and smoking (in particular). However, the factors associated with more severe conditions, and therefore potential aggravators of the disease, remain a matter of debate. Our study aims to determine the clinical factors associated with severe HS using several severity scores.
The data were obtained via the ERHS questionnaire from patients exclusively recruited at Erasme Hospital in Brussels. The severity of HS was firstly estimated by the Hurley score, and secondly by a metascore, a system combining the iHS4, HS-PGA, SAHS, and DLQI. Univariable and multivariable analyses were performed.
Six hundred and forty-seven patients were included in the Hurley analysis, and 456 patients in the metascore analysis. In multivariable analysis, men have a more severe metascore than women (odds ratio [OR] = 1.89, p = 0.022), smoking was associated with a more severe disease according to metascore, especially in mild cases (OR = 0.76, p = 0.043), and an elevated body mass index was associated with having Hurley stage III disease compared to Hurley I or II disease (OR = 1.09, p = 0.001). A significant association is also shown between blood pressure and Hurley stage (OR = 0.97, p = 0.025). Self-reports of nonsteroidal anti-inflammatory drugs aggravating the disease is also a factor associated with greater severity according to the metascore (OR = 0.12, p = 0.008). Finally, several locations of HS lesions were associated with greater severity, in particular the armpits according to the metascore (OR = 0.29, p < 0.001), and the perianal area according to the Hurley score (OR = 0.15, p < 0.001).
HS seems to be more severe in men; smoking seems to aggravate mild cases of HS, while increased body mass index plays a major role in the transition from Hurley II to Hurley III.
化脓性汗腺炎（HS）是一种慢性炎症性皮肤病，某些风险因素广为人知，尤其是肥胖和吸烟。然而，与更严重病情相关的因素，即该病的潜在加重因素，仍存在争议。我们的研究旨在使用多种严重程度评分来确定与重度HS相关的临床因素。
数据通过ERHS问卷从仅在布鲁塞尔伊拉斯谟医院招募的患者中获得。HS的严重程度首先通过赫尔利评分进行评估，其次通过综合iHS4、HS-PGA、SAHS和DLQI的综合评分系统进行评估。进行了单变量和多变量分析。
647名患者纳入赫尔利分析，456名患者纳入综合评分分析。在多变量分析中，男性的综合评分比女性更严重（优势比[OR]=1.89，p=0.022），根据综合评分，吸烟与病情更严重相关，尤其是在轻度病例中（OR=0.76，p=0.043），与赫尔利I期或II期疾病相比，体重指数升高与赫尔利III期疾病相关（OR=1.09，p=0.001）。血压与赫尔利分期之间也显示出显著关联（OR=0.97，p=0.025）。根据综合评分，非甾体抗炎药加重病情的自我报告也是与病情更严重相关的一个因素（OR=0.12，p=0.008）。最后，HS病变的几个部位与病情更严重相关，特别是根据综合评分的腋窝（OR=0.29，p<0.001），以及根据赫尔利评分的肛周区域（OR=0.15，p<0.001）。
HS在男性中似乎更严重；吸烟似乎会加重轻度HS病例，而体重指数增加在从赫尔利II期向赫尔利III期的转变中起主要作用。
