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Multicenter Study
. 2014 Oct;171(4):819-24.
doi: 10.1111/bjd.13090. Epub 2014 Sep 7.

Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: a cross-sectional study

C B Kromann  1 , I E Deckers, S Esmann, J Boer, E P Prens, G B E Jemec
Affiliations
Multicenter Study

Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: a cross-sectional study

C B Kromann et al. Br J Dermatol. 2014 Oct.

Abstract

Background: Hidradenitis suppurativa (HS) causes considerable morbidity. The long-term prognosis is of obvious interest to both patients and physicians. We conducted this study to determine the prognosis and risk factors in patients diagnosed with HS.

Objectives: To describe the long-term prognosis and the clinical course of HS and its association to known risk factors.

Methods: A postal follow-up survey with uncomplicated factual questions was conducted. As all of the patients were well acquainted with their long-standing disease, this was thought to be sufficient for meaningful results. All cases were diagnosed by a dermatologist. Overall, 212 patients diagnosed with HS between 1981 and 2001 were studied after a median follow-up period of 22 years (range 12-32).

Results: The overall response rate was 71.2%, with 60.8% (129/212) valid (fully completed) questionnaires. Remission was reported by 39.4% (50/127) and improvement by 31.5% (40/127). Unchanged severity was reported by 20.5% (26/127), and 8.7% (11/127) experienced worsening disease. Tobacco smoking was reported by 92.2% (119/129). Among nonsmokers, 40% (35/88) reported remission vs. 29% (17/59) of active smokers. A higher proportion of nonobese patients (45%) reported remission than obese patients (23%).

Conclusions: We found that 39.4% of the sample reported remission of HS. Suspected risk factors appeared to influence the prognosis. Smoking and obesity were significantly linked to a lower rate of self-reported remission. The notion that lifestyle factors play a role in HS appears to be supported by this survey.

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