The Point Prevalence of Malignancy in a Wound Clinic.

The aim of this study was to determine the prevalence of malignant leg ulcers and to identify the most frequent characteristics of such wounds. This study was a retrospective investigation of patients with chronic leg ulcers in a North American tertiary wound clinic. Between January 2011 and September 2013, a total of 1189 patients with lower extremity wounds, including 726 patients with leg wounds, were identified. A total of 124 of the 726 had undergone a biopsy of their atypical wound, 16.1% (20/124) of which were malignant. Patients with malignant wounds were older than patients with nonmalignant leg wounds (P < .0001), and the common location of the malignant wound was the anterior shin (odds ratio = 3.5). The limitation of this analysis is the lack of distinction between malignant transformation of wounds and de novo presentation of malignancies as chronic nonhealing wounds. Three distinguishing morphological features in malignant wounds were irregular borders (P = .0002), presence of hypergranulation tissue (P < .0001), and friable/bleeding wound surface (P < .0001). The frequency of malignant wounds in patients with chronic leg ulcers highlights the need for a systematic approach, which would involve biopsy of wounds to identify malignancy in this patient population early on.

Clinical Features and Patient Outcomes of Hidradenitis Suppurativa: A Cross-Sectional Retrospective Study.

BACKGROUND: Despite the high burden of disease associated with hidradenitis suppurativa (HS), epidemiologic data are scarce. OBJECTIVE: The objective was to review demographic features and clinical findings in 80 HS patients from 2 referral centres in Ontario, Canada, from October 2013 to September 2014, and to assess for factors that are associated with more advanced disease. METHODS: Multicentre cross-sectional study. The data on demographic and clinical features were obtained by questionnaires and chart review. RESULTS: Of a total of 80 patients (67.5% females), percentages of patients in Hurley stages I, II, and III were 15.4%, 55.8%, and 28.9%, respectively. Most patients were not diagnosed for more than 1 year (70.1%). Patients with more severe disease were more likely to be females and to have a greater number of lesions and were less likely to be diagnosed initially by a dermatologist. CONCLUSIONS: This study documents the common demographic and clinical features of HS to optimize resource allocation and patient outcomes.

Quality-of-life impairment in patients with hidradenitis suppurativa: a Canadian study.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic relapsing condition with a clinical picture that includes solitary nodules; diffuse, painful abscesses; malodorous drainage; sinus tract formation; and scarring. Treatment options are often unsatisfactory. The adverse effects of this disease on quality of life (QoL) is not extensively studied, especially in the Canadian population. OBJECTIVES: The objectives of this study were to (1) identify the impairment of QoL in patients with HS and the aspects that are most affected, and (2) assess the correlation between disease severity (based on Hurley's staging) and QoL impairment. METHODS: This prospective case series studied 55 patients (38 females and 17 males) from community dermatology clinics in Ontario. All patients filled out the questionnaires for QoL data using the Dermatology Life Quality Index (DLQI) and the Short Form 36 Version 2 (SF-36v2) health survey, either in the clinic or over the telephone. RESULTS: The mean DLQI score was 10 ± 8.8, indicating a moderate effect on patients' lives. In keeping with this, SF-36v2 scores were significantly reduced with respect to both physical and mental health. The severity of disease, as measured by Hurley staging, the number of lesions, and patient-reported QoL were significantly correlated with the DLQI score (ß = 0.549, 0.285, 0.390, respectively; p = 0.000, 0.045, 0.004, respectively; α = 0.05). CONCLUSIONS: The impact on QoL for patients with HS is extensive yet underestimated; quantifying and assessing the burden of disease for the individual and society will lead to establishment of funding priorities and greater awareness of this condition.