Assessing the severity of hidradenitis suppurativa

Hidradenitis suppurativa is a chronic condition in which boil‐like lumps develop in the armpits and groins, under the breasts and around the buttocks. There is often a delay in making a diagnosis, as it is often misdiagnosed as infection. The lesions are often painful and the condition greatly impairs quality of life. Measuring the severity of a disease allows doctors to see whether it improves as a result of treatment. Although there are several methods that can be used to measure the severity of hidradenitis suppurativa in the research setting, they can be too cumbersome for use in a busy general clinic. Patient Global Assessment (PtGA) is a method that has proved to be useful in assessing disease severity in other chronic conditions such as rheumatoid arthritis. In this paper, the authors from Wales, Denmark and the USA developed a PtGA specifically for use by patients with hidradenitis suppurativa, developing it with focus groups of patients with the condition. They then recruited 441 patients with hidradenitis suppurativa attending clinics in the USA and Denmark, either face to face or by telephone. The researchers measured the severity of disease using the PtGA along with other methods: Hidradenitis Suppurativa Quality of Life (HiSQOL – a measure specific to people with hidradenitis suppurativa), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS) and measures of pain. They found that the PtGA gave consistent results on repeat testing and provided an accurate measure of disease severity, as it correlated well with the HiSQOL and pain scale. It was less effective at determining changes in disease activity. The authors conclude that the PtGA could be a useful quick tool in the busy clinic setting. Linked Article :  Kirby et al . Br J Dermatol 2021; 184 :681–687.