Psychosocial Implications and Quality of Life in Patients with Hidradenitis Suppurativa Compared to Those With Atopic Dermatitis and Psoriasis: a Cross-sectional Case-control Study

Alya AlSiyoufi; Saleh Almohaimeed; Sawsan Alsiyoufi; Louai Salah

doi:10.5826/dpc.1302a76

Psychosocial Implications and Quality of Life in Patients with Hidradenitis Suppurativa Compared to Those With Atopic Dermatitis and Psoriasis: a Cross-sectional Case-control Study

Authors

Alya AlSiyoufi Department of Dermatology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Saleh Almohaimeed Department of Dermatology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Sawsan Alsiyoufi Department of Dermatology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Louai Salah Department of Dermatology, Ministry of Health, East Jeddah General Hospital, Jeddah, Saudi Arabia

Keywords:

Hidradenitis suppurativa, chronic inflammatory skin disease, quality of life, Dermatology Life Quality Index, Rosenberg Self-Esteem Scale

Abstract

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that has been reported to have the greatest negative impact on quality of life (QoL) and psychosocial factors when compared with other skin conditions.Objectives: To assess psychosocial impact and QoL impairment in patients with HS.Methods: This cross-sectional case-control study included a case group with HS and a control group with psoriasis or atopic dermatitis diagnosed by a dermatologist at a public hospital in Jeddah, Saudi Arabia from 2016 to 2019. Data were obtained from medical records at a ratio of 1:2. Patients were contacted via telephone and asked to complete Arabic-validated questionnaires (Dermatology Life Quality Index [DLQI], Rosenberg Self-Esteem Scale, and Hospital Anxiety and Depression Scale) and a survey containing pictures to identify Hurley stage.Results: The study included 46 patients and 101 controls (eczema, 50; psoriasis, 51). Patients had significantly higher DLQI and depression scores than did controls (P < 0.05). Anxiety and depression scores were significantly higher in women than men (P < 0.05). Cases with Hurley stage 3 had significantly higher DLQI scores than those with Hurley stages 1 and 2. Controls had a significantly higher percentage of employed participants (P < 0.05).Conclusions: HS had a greater psychosocial impact on QoL than psoriasis or atopic dermatitis and was associated with a lower employment rate. Women were more affected by the disease than men. Therefore, we recommend paying close attention to the psychosocial aspects of the disease and establishing educational programs and support groups for patients with HS.

References

Kouris A, Platsidaki E, Christodoulou C, et al. Quality of life and psychosocial implications in patients with hidradenitis suppurativa. Dermatology. 2019;232(6):687–691. DOI: 10.1159/000453355. PMID: 28052274.

Ruggiero A, Martora F, Picone V, Marano L, Fabbrocini G, Marasca C. Paradoxical hidradenitis suppurativa during biologic therapy, an emerging challenge: a systematic review. Biomedicines. 2022;10(2):455. DOI: 10.3390/biomedicines10020455. PMID: 35203664. PMCID: PMC8962303

Martora F, Martora L, Fabbrocini G, Marasca C. A case of pemphigus vulgaris and hidradenitis suppurativa: may systemic steroids be considered in the standard management of hidradenitis suppurativa? Skin Appendage Disord. 2022;8(3):265–268. DOI: 10.1159/000521712. PMID: 35707292. PMCID: PMC9149405

Shirah B, Shirah H. The clinical pattern of axillary hidradenitis suppurativa among Saudi Arabians: mode of presentation and treatment challenges. J Cutan Aesthet Surg. 2017;10(2):95–100. DOI: 10.4103/JCAS.JCAS_80_16. PMID: 28852296. PMCID: PMC5561718

Ather S, Chan DSY, Leaper DJ, Harding KG. Surgical treatment of hidradenitis suppurativa: case series and review of the literature. Int Wound J. 2006;3(3):188–189. DOI: 10.1111/j.1742-481X.2006.00235.x. PMID: 16984573. PMCID: PMC7951451

Balik E, Eren T, Bulut T, Buyukuncu Y, Bugra D, Yamaner S. Surgical approach to extensive hidradenitis suppurativa in the perineal/perianal and gluteal regions. World J Surg. 2009;33(3):481–487. DOI: 10.1007/s00268-008-9845-9. PMID: 19067039.

Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158–164. DOI: 10.1056/NEJMcp1014163. PMID: 22236226.6.

König A, Lehmann C, Rompel R, Happle R. Cigarette smoking as a triggering factor of hidradenitis suppurativa. Dermatology. 1999;198(3):261–264. DOI: 10.1159/000018126. PMID: 10393449.

Sartorius K, Emtestam L, Jemec G, Lapins J. Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol. 2009;161(4):831–839. DOI: 10.1111/j.1365-2133.2009.09198.x. PMID: 19438543.

Alhusayen R, Shear NH. Pharmacologic interventions for hidradenitis suppurativa. Am J Clin Dermatol. 2012;13(5):283–291. DOI: 10.2165/11631880-000000000-00000. PMID: 22676319.

Alavi A, Anooshirvani N, Kim WB, Coutts P, Sibbald RG. Quality-of-life impairment in patients with hidradenitis suppurativa: a Canadian study. Am J Clin Dermatol. 2015;16(1):61–65. DOI: 10.1007/s40257-014-0105-5. PMID: 25432664.

Bin Saif GA, Al-Balbeesi AO, Binshabaib R, et al. Quality of life in family members of vitiligo patients: a questionnaire study in Saudi Arabia. Am J Clin Dermatol. 2013;14(6):489–495. DOI: 10.1007/s40257-013-0037-5. PMID: 23839260.

Rice V, Weglicki L, Templin T, Hammad A, Jamil H, Kulwicki A. Predictors of Arab American adolescent tobacco use. Merrill Palmer Q. 2006;52(2):327–342. DOI: 10.1353/mpq.2006.0020. PMID: 16909165. PMCID: PMC1533871

Terkawi AS, Tsang S, AlKahtani GJ, et al. Development and validation of Arabic version of the Hospital Anxiety and Depression Scale. Saudi J Anaesth. 2017;11(Suppl 1):S11–S18. DOI: 10.4103/sja.SJA_43_17. PMID: 28616000. PMCID: PMC5463562

European HS Foundation. Hidradenitis suppurativa online. Accessed October 22, 2019. Available from https://www.hsonlinearabia.com/en_ae/home.html

Matusiak L, Bieniek A, Szepietowski JC. Psychophysical aspects of hidradenitis suppurativa. Acta Derm Venereol. 2010;90(3):264–268. DOI: 10.2340/00015555-0866. PMID: 20526543.

Smith HS, Chao JD, Teitelbaum J. Painful hidradenitis suppurativa. Clin J Pain 2010; 26(5):435–444. DOI: 10.1097/AJP.0b013e3181ceb80c. PMID: 20473053.

Esmann S, Jemec GB. Psychosocial impact of hidradenitis suppurativa: a qualitative study. Acta Derm Venereol. 2011;91(3):328–332. DOI: 10.2340/00015555-1082. PMID: 21394419.

Kokolakis G, Wolk K, Schneider-Burrus S, et al. Delayed diagnosis of hidradenitis suppurativa and its effect on patients and healthcare system. Dermatology 2020;236(5):421–430. DOI: 10.1159/000508787. PMID: 32610312. PMCID: PMC7592906

Saunte DM, Boer J, Stratigos A, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol. 2015;173(6):1546–1549. DOI: 10.1111/bjd.14038. PMID: 26198191.

Abolfotouh MA, Al-Khowailed MS, Suliman WE, et al. Quality of life in patients with skin diseases in central Saudi Arabia. Int J Gen Med. 2012;5:633–642. DOI: 10.2147/IJGM.S33276. PMID: 22866015. PMCID: PMC3410718

Alavi A, Farzanfar D, Rogalska T, Lowes MA, Chavoshi S. Quality of life and sexual health in patients with hidradenitis suppurativa. Int J Womens Dermatol. 2018;4(2):74-79. DOI: 10.1016/j.ijwd.2017.10.007. PMID: 30023423. PMCID: PMC6047191

Janse IC, Deckers IE, van der Maten AD, et al. Sexual health and quality of life are impaired in hidradenitis suppurativa: a multicentre cross-sectional study. Br J Dermatol. 2017;176(4):1042–1047. DOI: 10.1111/bjd.14975. PMID: 27534591.