The Contribution of Malodour in Quality of Life of Patients With Hidradenitis Suppurativa

Abstract

Background: Malodourous discharge in patients with hidradenitis suppurativa (HS) has a strong psychosocial impact and is often reported as a source of embarrassment, low self-esteem, social stigma, and barriers to interpersonal relationships. Malodour is a maker of bacterial colonization, and its role in HS is understudied.

Objectives: The aim of this study is to assess the relationship between severity of malodourous discharge and quality-of-life impairment in patients with HS.

Methods: This is a cross-sectional study of 51 patients recruited from the Women's College Hospital and the York Dermatology Centre. Quality of life was assessed using both the Dermatology Life Quality Index (DLQI) and the Skindex-29 instruments.

Results: Severity of odour significantly predicts the total Skindex score after controlling for disease severity as measured by the Hurley stage and Sartorius score ( R² = 0.39, F = 8.11, P < .0001). However, odour severity is not a predictor of DLQI ( R² = 0.17, F = 2.63, P = .064). There was no difference in mean DLQI scores for the low- vs high-odour groups, but patients with high odour had a greater quality of life impairment as measured by the Skindex tool ( t = -4.19, df = 43, P < .0001, mean difference = -18.87).

Conclusion: Malodour is a common symptom that significantly impairs quality of life in patients with HS. The fact that this effect is captured in Skindex and not the DLQI may be attributed to the nonspecificity of the DLQI in terms of unique disease characteristics. It is important to address odour in the management of patients with HS.

Keywords: dermatology; hidradenitis; hidradenitis suppurativa; malodour; odour; quality of life.