Fig. 1).Īgreement and disagreement rates for each lesion type’s definition, pathophysiological classification, and imageĪs for the proposed definitions, disagreement rates >10% were detected for all terms except Hurley III. Materials and Methodsįor further details, see the online supplementary material (see all online suppl. To achieve this, we performed a survey of physicians attending the 5th Conference of the European HS Foundation (EHSF). The goal of this study was to develop a set of descriptive definitions and associated images of HS lesions, which may ultimately serve as a tool to help doctors to recognize and evaluate the disease better. Formal definitions of HS typical lesions may allow more precise and consistent scoring of the disease and, consequently, better treatment strategies, assessment of the treatment efficacy, and patients’ follow-up. The lack of accepted common definitions of HS typical lesions is likely to contribute to the problems experienced by patients such as the long delay in diagnosis, but it also explains why severity scores depending on lesion counts show great variation even among experts who commonly manage this disease. van der Zee and Jemec described 6 different types of clinical presentations of the disease, but the aim of their work was to focus more on pathophysiology than descriptive definitions. proposed new terms related to more severe cases of HS (such as multicord and multitunnel). made a systematic review of the terms used to describe HS in order to elaborate a glossary, but the terms abscess, scar, fistula, and comedo were excluded from it. Recently, Scheinfeld established an exhaustive atlas of images of typical lesions of HS, but with no definition. A list of lesions without accompanying definitions was also given by the modified Dessau definition. in 2006 accompanied by a partial description, but no complete definition. A list of lesions typical of the disease was provided by Jemec et al. The number of publications concerning HS has constantly increased over the last 2 decades, but very few described what typical lesions of HS are. Although the diagnosis of HS relies on clinical criteria only (i.e., the chronic-recurrent presence of HS typical lesions, distributed according to the typical topography of the disease), agreement on definitions of HS typical lesions appears to be low in daily practice. Despite this, HS frequently appears to be under-recognized by physicians, which is supported by the long delay in diagnosis. European studies estimate HS prevalence in various populations at 1–4%.
Hidradenitis suppurativa 3rd most painful disease skin#
Hidradenitis suppurativa (HS) is a chronic skin disease characterized by painful, inflamed lesions located predominantly in the axillae, groins, and perineal/perianal areas. This set could ultimately serve as a tool to better recognize, score, and assess treatment efficacy. Conclusion: A user-friendly set of definitions/images of HS typical lesions was proposed and will need to be validated by further studies. Pathophysiological classifications were dropped. Their agreement/disagreement rates and comments were used to obtain a revised set of definitions and images.
Results: A total of 81 physicians answered the questionnaire. The physicians attending the event were invited to vote on each term and make comments via a voting sheet. This preliminary set was shown during the 5th Conference of the European HS Foundation (EHSF). Each term was associated with a pathophysiological classification and an image. A preliminary set of definitions of HS typical lesions was created, including 10 terms. Methods: MEDLINE-available literature and dermatological textbooks on HS morphology were retrieved (January 1996 to February 2016).
Our aim was to develop a set of descriptive definitions and associated images of HS lesions, in order to enable doctors to better recognize and evaluate the disease.
The diagnosis of HS is clinical via the recognition of lesions typical of the disease, but universally accepted definitions of these latter are currently lacking, which means that certain severity scores employed for HS classification/management are used differently by different physicians. Background: Although not rare, hidradenitis suppurativa (HS) is often under-recognized by physicians.
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