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Evaluation of medical and surgical treatments for hidradenitis suppurativa using real‐life data from the Scandinavian registry ( HISREG )
Author(s) -
Grimstad Ø.,
Tzellos T.,
Dufour D.N.,
Bremnes Ø.,
Skoie I.M.,
Snekvik I.,
Jarnæss E.,
Kyrgidis A.,
Ingvarsson G.
Publication year - 2019
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15353
Subject(s) - medicine , minimal clinically important difference , hidradenitis suppurativa , dermatology life quality index , quality of life (healthcare) , physical therapy , visual analogue scale , psychological intervention , surgery , randomized controlled trial , disease , nursing , psychiatry
Abstract Background Hidradenitis suppurativa ( HS ) substantially affects health‐related quality‐of‐life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. Objective The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician‐ and patient‐reported outcomes registered in HISREG . Methods Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index ( DLQI ) scores, pain as measured using a numeric rating scale ( NRS ), Sartorius score and Hurley classification. Minimum clinically important differences ( MCID s) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. Results Two hundred and fifty‐five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO 2 lasers was the most common treatment modality. One hundred and forty‐nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti‐inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline ( P = 0.001), 83 patients (55%) achieved a DLQI MCID , and 75 patients (49.7%) achieved an NRS pain MCID . In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline ( P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID . In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCID s and Sartorius scores were significantly improved. Conclusions CO 2 laser treatment is more effective than the non‐biologic medical treatments in this analysis based on physician‐ and patient‐derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS .