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2.
J Natl Med Assoc ; 114(6): 613-616, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36511276

RESUMO

Hidradenitis suppurativa is a chronic, debilitating skin disease that disproportionately affects African Americans, and care-related factors may contribute to this disparity. In this study, we investigated delay in diagnosis and dermatologic care for HS at an urban Midwestern Academic Center. A retrospective chart review of 1,190 patients with 3 or more encounters for HS between 1/1/2002 and 3/19/2019 was conducted. A total of 953 patients were included in statistical analysis. A mean (standard deviation) delay in diagnosis was 4.1 ± 7.0 years. For white patients the delay in diagnosis was 3.2 ± 6.3 years, for Black patients 4.8 ± 7.0 years, for Hispanic patients 4.7 ± 5.8 years, and for other races 4.9 ± 7.4 years (p <0.001). Among the 932 patients with known specialist visit types, 500 (53.6%) had seen dermatology including 222 (47.8%) of Black patients, 242 (59.5%) of white patients, 24 (64.9%) of Hispanic patients, and 12 (50%) patients of other races (p=0.003).White patients and Hispanic patients saw a dermatologist an average of 3.0 years after first presentation of HS and Black patients saw a dermatologist on average 5.0 years after first presentation (p=0.004). Of the patients who did see dermatology, 44.9% of Black patients, 31.6% of white patients, 23.1% of Hispanic patients, and 30.8% of other races saw surgery before dermatology (p<.001). Our results indicate that non-white patients have a longer delay in diagnosis than their white counterparts and that Black patients do not see dermatology as early in their disease course as other racial groups. Black patients also see surgery more often than white patients before seeing dermatology, which could suggest greater disease severity at presentation and diagnosis or difficult access to dermatology.


Assuntos
Hidradenite Supurativa , Humanos , Estudos Retrospectivos , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Hispânico ou Latino
4.
Medicine (Baltimore) ; 101(44): e31144, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36343026

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory and debilitating dermatosis characterized by painful nodules, sinus tracts and abscesses in apocrine gland-bearing areas that predominantly affect women worldwide. New therapeutic interventions based on the clinical manifestations of patients have recently been introduced in numerous articles. However, which countries, journals, subject categories, and articles have the ultimate influence remain unknown. This study aimed to display influential entities in 100 top-cited HS-related articles (T100HS) and investigate whether medical subject headings (i.e., MeSH terms) can be used to predict article citations. METHODS: T100HS data were extracted from PubMed since 2013. Subject categories were classified by MeSH terms using social network analysis. Sankey diagrams were applied to highlight the top 10 influential entities in T100HS from the three aspects of publication, citations, and the composited score using the hT index. The difference in article citations across subject categories and the predictive power of MeSH terms on article citations in T100HS were examined using one-way analysis of variance and regression analysis. RESULTS: The top three countries (the US, Italy, and Spain) accounts for 54% of the T100HS. The T100HS impact factor (IF) is 12.49 (IF = citations/100). Most articles were published in J Am Acad Dermatol (15%; IF = 18.07). Eight subject categories were used. The "methods" was the most frequent MeSH term, followed by "surgery" and "therapeutic use". Saunte et al, from Roskilde Hospital, Denmark, had 149 citations in PubMed for the most cited articles. Sankey diagrams were used to depict the network characteristics of the T100HS. Article citations did not differ by subject category (F(7, 92) = 1.97, P = .067). MeSH terms were evident in the number of article citations predicted (F(1, 98) = 129.1106; P < .001). CONCLUSION: We achieved a breakthrough by displaying the characteristics of the T100HS network on the Sankey diagrams. MeSH terms may be used to classify articles into subject categories and predict T100HS citations. Future studies can apply the Sankey diagram to the bibliometrics of the 100 most-cited articles.


Assuntos
Hidradenite Supurativa , Fator de Impacto de Revistas , Humanos , Feminino , Hidradenite Supurativa/terapia , Bibliometria , Medical Subject Headings , PubMed
5.
J Wound Care ; 31(11): 898-906, 2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36367803

RESUMO

OBJECTIVE: It is theorised that adhesive-free wound care developed specifically for patients with hidradenitis suppurativa (HS) can improve their quality of life (QoL). Our study aimed to investigate the impact of a novel wound care device on Dermatology Life Quality Index (DLQI) scores, and other factors related to experienced pain, time spent changing dressings, comfort, ease of use and body image. METHOD: A 21-day, single-arm, unblinded, pilot trial was conducted to assess ease of use and the impact of effective wound care on various aspects of wound management in patients with HS. Participants were provided two trial garments and trial dressings as required, to use over a 21-day period in the home setting. A seven-item questionnaire and the DLQI questionnaire was completed on days 0, 7, 14 and 21. RESULTS: All 15 participants were female, aged >18 years old and with a diagnosis of HS. Mean DLQI score at baseline (day 0) was 19.3, which was reduced to 4.53 on day 21, a significant improvement in 100% of participants (p<0.001). High levels of dressing-related pain, assessed using an 11-point Visual Analogue Scale, reduced from 5.53 at baseline to 0.8 on day 21. Other significant improvements in terms of patient comfort, time spent on changing dressings, body confidence and the dressing's ability to retain exudate were also noted. CONCLUSION: The results illustrated the improvement made to study participants' day-to-day activities and QoL when effective HS-specific wound care products were provided. Wound care is an essential component in the treatment journey of patients.


Assuntos
Hidradenite Supurativa , Humanos , Feminino , Adolescente , Masculino , Hidradenite Supurativa/terapia , Hidradenite Supurativa/diagnóstico , Qualidade de Vida , Projetos Piloto , Bandagens , Dor/etiologia
6.
J Dtsch Dermatol Ges ; 20(11): 1441-1452, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36321358

RESUMO

BACKGROUND AND OBJECTIVES: Treatment options for moderate-to-severe hidradenitis suppurativa (HS) comprise antibiotics, biologics, and different surgical methods. These approaches differ substantially regarding the treatment process, success rates, and adverse events. However, information on patient preferences for HS therapies is hitherto scarce. Our aim was to assess patient preferences for medicamentous and surgical treatment of HS with conjoint analysis. PATIENTS AND METHODS: In this cross-section study, computerized discrete choice experiments were used to quantify patient preferences for HS therapies decomposed into treatment modality (tablets, subcutaneous injections, surgery with secondary-intention healing or primary closure), probability of sustained therapeutic success, probability of mild or severe adverse events, and duration of treatment or wound healing. RESULTS: Averaged over the cohort (n  =  216 patients with HS), sustained therapeutic success was considered as most important (Relative Importance Score [RIS]: 36.2), followed by the treatment modality (RIS: 24.0), and duration of treatment/wound healing (RIS: 19.9), whereas mild or severe adverse events (RIS: 10.7 or 9.3) were regarded as less relevant. Patients preferred tablets, followed by subcutaneous injections, and disliked surgery with primary closure. Preferences differed significantly dependent on age and affected body regions. CONCLUSIONS: Awareness of patient preferences is essential for patient-centered care in HS.


Assuntos
Produtos Biológicos , Hidradenite Supurativa , Humanos , Hidradenite Supurativa/terapia , Hidradenite Supurativa/tratamento farmacológico , Preferência do Paciente , Produtos Biológicos/uso terapêutico , Cicatrização , Antibacterianos/uso terapêutico
9.
Am J Clin Dermatol ; 23(6): 841-852, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36116091

RESUMO

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease comprising painful abscesses, deep nodules, fistulas, and scarring predominantly in the axilla and groin. Bacterial colonization of HS lesions has been well characterized and may lead to chronic infection of lesions. While disease pathogenesis of HS is not fully understood, there is increasing evidence that microbial dysbiosis may be occurring in numerous locations, including the skin and gut. The skin-gut microbiome has been proposed as a mechanism by which inflammatory skin disorders, including HS, can be exacerbated. This is evidenced by HS patients being significantly more likely to develop inflammatory bowel disease as well as the well documented cutaneous manifestations in inflammatory bowel disease. In this review, we discuss the current literature regarding HS skin and gut microbiome research. Furthermore, we discuss further considerations for microbiome research in HS, including the potential role of bacterial metabolites in disease progression and future therapeutic avenues like probiotics.


Assuntos
Microbioma Gastrointestinal , Hidradenite Supurativa , Doenças Inflamatórias Intestinais , Microbiota , Hidradenite Supurativa/patologia , Hidradenite Supurativa/terapia , Humanos , Pele/patologia
10.
J Fam Pract ; 71(7): E17-E18, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36179144

RESUMO

THE COMPARISONSevere longstanding hidradenitis suppurativa (Hurley stage III) with architectural changes, ropy scarring, granulation tissue, and purulent discharge in the axilla of A 35-year-old Black man. A 42-year-old Hispanic woman with a light skin tone.


Assuntos
Hidradenite Supurativa , Adulto , Axila , Feminino , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Humanos , Masculino
12.
J Cutan Med Surg ; 26(2_suppl): 2S-24S, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36000460

RESUMO

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that is characterized by the formation of comedones, papules, nodules, abscesses and sinus tracts in the axillary, inframammary, groin, and gluteal areas. Up to 3.8% of the Canadian population has HS, though due to a lack of awareness of HS, many patients are initially misdiagnosed and do not receive adequate treatment early on in the disease course. Once a diagnosis of HS is made, developing an effective management plan can be a dilemma for many providers. There is significant variability in response to any given therapy within the HS patient population and many HS patients have other medical comorbidities which must be taken into consideration. The aim of this review is to provide a practical approach for all healthcare providers to diagnose and manage HS and its associated comorbidities. A sample electronic medical record template for HS management was developed by the Canadian Hidradenitis Suppurativa Foundation Executive Board and is intended for use in clinical settings. This will help to increase collaboration between primary healthcare providers, dermatologists, and other medical specialists and ultimately improve the quality of care that HS patients receive.


Assuntos
Hidradenite Supurativa , Guias de Prática Clínica como Assunto , Canadá/epidemiologia , Comorbidade , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/epidemiologia , Hidradenite Supurativa/terapia , Humanos
13.
Br J Dermatol ; 187(6): 846-854, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35962565

RESUMO

BACKGROUND: Pain is the most common and bothersome symptom experienced by people with hidradenitis suppurativa (HS) and has been prioritized as an outcome domain by the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC). OBJECTIVES: To perform a scoping review of pain measurement in randomized control trials (RCTs) of painful skin conditions (PSCs) and use of the pain numerical rating scale (NRS) and visual analogue scale (VAS) in rheumatoid arthritis RCTs, to inform the efforts of HISTORIC to reach consensus on how to measure pain intensity in HS trials. METHODS: A search was conducted on several publication databases. Inclusion criteria were RCTs with a minimum of 10 participants that measured pain intensity. RESULTS: Pain NRS and VAS were used in 68% of PSC trials. Respectively, 77% and 87% of PSC and rheumatoid arthritis RCTs did not specify the recall window. The commonest recall window in PSCs when specified was 24 h. In total, 33% of PSC trials assessed maximum pain intensity and 3% average pain intensity, while 87% of rheumatoid arthritis trials did not provide details. Pain data were reported as mean difference by 76% of PSC trials and 75% of rheumatoid arthritis trials. Respectively, 10% and 11% of PSC and rheumatoid arthritis studies reported pain as the percentage of patients reaching a desirable state and only 1% and 2% reported number needed to treat. CONCLUSIONS: While pain NRS and VAS are standard methods to measure pain intensity in PSCs, key details such as the recall window are often omitted and there is no consensus on how to report pain NRS data. What is already known about this topic? Pain is the most burdensome symptom experienced by patients with hidradenitis suppurativa and has been prioritized as an outcome domain by the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC). What does this study add? Our review shows substantial variation in how pain numerical rating scale (NRS) and visual analogue scale are utilized in clinical trials. This variation restricts meta-analysis of pain intensity results. There is a need for consensus regarding the recall window for pain NRS and maximum vs. average pain, and whether current pain should be measured.


Assuntos
Artrite Reumatoide , Hidradenite Supurativa , Humanos , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Dor/diagnóstico , Dor/etiologia
15.
J Dtsch Dermatol Ges ; 20(8): 1061-1072, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35821567

RESUMO

Data regarding hidradenitis suppurativa (HS)-related expenditure is limited and non-homogeneous, but HS does incur significant expenses. We performed a systematic review of literature reports documenting financial data regarding any healthcare domain or other expenditure incurred by HS and/or HS impact on work, income and personal economic growth (indirect costs). Three electronic databases were searched (MEDLINE, ScienceDirect, and the Cochrane Library - last search date: September 14th , 2021). All costs were adjusted for inflation (2022) and converted into US dollars. Twenty-three papers were included (18 cost-of-illness studies, 4 observational studies and 1 case series), drawing economic data from 77,287 HS patients. The total mean cost incurred by HS per patient per year ranged from $ 258 to $ 8,078. This number increased in case of surgical intervention, disease progression, antibiotic failure and certain comorbid diseases. The costliest healthcare sector was inpatient care, followed by outpatient and emergency care. Significant differences were observed between the USA and the rest of studied countries. Hospitalization was likelier, lengthier, and costlier for HS compared to psoriasis patients, whereas the less costly outpatient care appeared to be reduced among HS patients. Preventing disease progression by optimizing early diagnosis and dermatology outpatient care could decrease HS-related expenditure.


Assuntos
Hidradenite Supurativa , Atenção à Saúde , Progressão da Doença , Gastos em Saúde , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Hospitalização , Humanos
16.
Adv Skin Wound Care ; 35(7): 381-384, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35723957

RESUMO

OBJECTIVE: Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin disease with a higher prevalence in women. The disease results in a low quality of life as well as physical and psychological comorbidities. The authors sought to determine the effects of HS on women's self-perception and life experiences. METHODS: Semistructured interviews were conducted with 22 women of varying age and family status. The content was transcribed and subjected to both thematic and content analyses. RESULTS: Five themes and a number of subthemes were revealed, involving physical, emotional, coping, and functional aspects. Somatic features, especially pain, were the most troubling issues, along with the emotional burden of shame and loss of femininity and intimacy. However, women also revealed strength and expressed optimism. CONCLUSIONS: These findings reveal the inner world of women coping with HS, addressing multiple dilemmas, problems, and concerns. Healthcare providers should pay special attention to the specific needs of these patients. Additional research is needed to further shed light on the impact of HS on women.


Assuntos
Hidradenite Supurativa , Comorbidade , Feminino , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/epidemiologia , Hidradenite Supurativa/terapia , Humanos , Dor , Prevalência , Qualidade de Vida
19.
Adv Skin Wound Care ; 35(6): 1-8, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703854

RESUMO

ABSTRACT: Diagnosing and treating neutrophilic dermatoses (NDs) in clinical practice can be challenging because of various presentations and stubborn treatment responses. Establishing a diagnosis is necessary, though, because many NDs are associated with underlying conditions, including malignancy. In this article, the authors provide information about Sweet syndrome, pyoderma gangrenosum, and other NDs and describe their clinical presentation, pathophysiology, diagnostic criteria, and associated conditions. The authors also present a case report describing the coexistence of two NDs and hidradenitis suppurativa in one patient and review the treatment modalities for those conditions.


Assuntos
Dermatite , Hidradenite Supurativa , Pioderma Gangrenoso , Síndrome de Sweet , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Humanos , Pioderma Gangrenoso/tratamento farmacológico , Pioderma Gangrenoso/terapia , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/patologia
20.
Pediatr Dermatol ; 39(5): 689-694, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35766518

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) often develops in pediatrics, but few interventional studies include pediatric patients. OBJECTIVES: This dual analysis of a pediatric HS cohort and typical eligibility criteria in adult trials aims to identify potential patient characteristics and inclusion criteria for future pediatric HS studies. METHODS: This cross-sectional and descriptive study is based on a prospectively collected data registry from an HS clinic. We also queried 125 HS studies from the Clinicaltrials.gov database and information from 61 interventional systemic HS drug trials was analyzed. RESULTS: The mean abscess and inflammatory nodule (AN) count in 81 pediatric subjects was 2.3 compared to 5.0 in adults with majority being Hurley stage I (39.5%, 32/81) or II (55.6%, 45/81). Most clinical trials required patients to be Hurley stage II/III with AN count of ≥3. CONCLUSION: When developing clinical trials for pediatric HS, it is imperative to consider how baseline characteristics impact recruitment and disease assessment. Frequently used eligibility criteria in adult trials may severely limit pediatric recruitment. Although our registry had a large adult sample size, the main limitation of this study was the relatively smaller pediatric sample size.


Assuntos
Ensaios Clínicos como Assunto , Hidradenite Supurativa , Seleção de Pacientes , Abscesso , Criança , Estudos Transversais , Hidradenite Supurativa/terapia , Humanos , Índice de Gravidade de Doença
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