Pain, Psychological Comorbidities, Disability, and Impaired Quality of Life in Hidradenitis Suppurativa [corrected]

Abstract

Purpose of review: Hidradenitis suppurativa (HS) is a chronic, painful dermatologic disease characterized by recurrent inflammatory nodules and abscesses of intertriginous areas such as the axilla and groin. People with HS suffer from greater pain and associated psychological comorbidities, including depression, anxiety, disability, and impairments in quality of life (QoL), compared to those with other dermatologic conditions. Our review focuses on the occurrence of pain and these relationships.

Recent findings: The existing literature indicates that acute and chronic pain, depression, anxiety, and disability all contribute to poor quality of life in individuals with HS. Despite the central role of pain and distress in the presentation of HS, few studies have empirically evaluated the impact of pain and gaps remain in the existing psychosocial literature. There are no formal guidelines for treating HS-specific pain or psychological comorbidities. The results of this review show a clear and pressing need to develop treatment recommendations and effective interventions for addressing acute and chronic pain, psychological comorbidities, disability, and impaired quality of life among people with HS. This review outlines a multidisciplinary approach to treating and managing pain and psychological comorbidities.

Keywords: Anxiety; Depression; Disability; Hidradenitis suppurativa; Pain; Quality of life.

Figure 1

Relationships between HS, pain, disability, quality of life, depression, and anxiety

Figure 2. Hurley Stages of Hidradenitis Lesions

Above are examples of HS lesions in the axilla. Stage I is characterized by mild disease limited to recurrent, acutely inflammatory cystic nodules (Panel A), that may be connected by isolated sinuses in Stage II (Panel B), or form a network of bridging sinuses in Stage III (Panel C) associated with odiferous, purulent drainage.