Ingram J R, Marzano A V, Prens E, Schneider-Burrus S, Warren R B, Keal A, Jha R, Hernandez Daly A C, Kimball A B
Division of Infection and Immunity, Cardiff University, University Hospital of Wales, Cardiff, UK.
Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Eur Acad Dermatol Venereol. 2025 Aug;39(8):1431-1441. doi: 10.1111/jdv.20550. Epub 2025 Feb 4.
Hidradenitis suppurativa (HS) is a chronic, inflammatory, neutrophilic skin disease associated with a considerable clinical burden. In more severe disease, subepidermal draining tunnels may form.
To characterize the clinical profile of patients with moderate-severe HS with and without draining tunnels, and the clinical and health-related quality of life (HR-QoL) burden of draining tunnels.
Data were drawn from the Adelphi HS Disease Specific Programme™, a cross-sectional survey with retrospective data collection, across the United States, France, Germany, Italy, Spain and the United Kingdom between November 2020 and April 2021. Patients were aged ≥10 years and had HS. Clinical outcomes, recorded by physicians, comprised patient demographics and HS characteristics, symptoms and treatment. HR-QoL measures included patient and physician survey questions, and validated HR-QoL instruments.
Of the 580 patients with moderate-severe HS, 46% had draining tunnels. Patients with draining tunnels had more abscesses, inflammatory nodules and scarring than those without. Patients with draining tunnels were significantly (p < 0.05) more likely to be treated with biologics (41% vs. 27%), but often patients with tunnels who were eligible for biologics had not received them. Patients with draining tunnels experienced significantly more inflammation/redness (73% vs. 63%), drainage from lesions (62% vs. 40%) and pain on sitting (48% vs. 37%) than those without (p < 0.05). Draining tunnels were also significantly associated with low mood/depression (30% vs. 18%), sleep disturbance (28% vs. 19%) and fatigue (28% vs. 18%) versus no tunnels (p < 0.05). Physicians agreed that patients with draining tunnels experienced a negative impact of disease compared to those without. This was reflected in patient-reported surveys and HR-QoL instruments.
Patients with moderate-severe HS and draining tunnels experience greater clinical and HR-QoL burden than those without, emphasizing the importance of tunnels in disease impact.
化脓性汗腺炎（HS）是一种慢性、炎症性、嗜中性皮肤病，会带来相当大的临床负担。在病情更严重时，可能会形成表皮下引流通道。
描述有和没有引流通道的中重度HS患者的临床特征，以及引流通道对临床和健康相关生活质量（HR-QoL）的负担。
数据来自阿德尔菲HS疾病特定项目™，这是一项在2020年11月至2021年4月期间在美国、法国、德国、意大利、西班牙和英国进行的回顾性数据收集横断面调查。患者年龄≥10岁且患有HS。医生记录的临床结果包括患者人口统计学和HS特征、症状及治疗情况。HR-QoL测量包括患者和医生调查问卷，以及经过验证的HR-QoL工具。
在580例中重度HS患者中，46%有引流通道。有引流通道的患者比没有的患者有更多脓肿、炎性结节和瘢痕形成。有引流通道的患者接受生物制剂治疗的可能性显著更高（41%对27%），但符合使用生物制剂条件的有引流通道的患者往往未接受治疗。有引流通道的患者比没有的患者经历更多炎症/发红（73%对63%）、病变部位渗液（62%对40%）和坐立时疼痛（48%对37%）（p<0.05）。与没有引流通道的患者相比，引流通道还与情绪低落/抑郁（30%对18%）、睡眠障碍（28%对19%）和疲劳（28%对18%）显著相关（p<0.05）。医生一致认为，有引流通道的患者与没有的患者相比，疾病产生了负面影响。这在患者报告的调查和HR-QoL工具中得到了体现。
有引流通道的中重度HS患者比没有的患者承受更大的临床和HR-QoL负担，这凸显了引流通道对疾病影响的重要性。
