Validation of the real-world application of the Hidradenitis Suppurativa Quality of Life (HiSQOL) score to adults with hidradenitis suppurativa.
Among skin diseases, hidradenitis suppurativa (HS) has unique symptoms and physical features. Patient-reported outcome measures (PROMs) unrelated to specific skin diseases may not fully characterize the influence of HS on quality of life (QoL). An HS-specific PROM is needed to capture the impact of HS on patients' QoL in a real-world setting.
To validate the Hidradenitis Suppurativa Quality of Life Questionnaire (HiSQOL) as an HS-specific PROM by comparing it with the Dermatology Life Quality Index (DLQI) in clinical practice.
Data were drawn from the Adelphi HS Disease Specific Programme™, a cross-sectional survey of physicians and patients conducted in France, Germany, Italy, Spain and the USA between November 2020 and April 2021. Practising physicians each provided demographic and clinical data for 5-7 consecutively evaluated patients with HS aged at least 10 years receiving any treatment for HS, and an additional 3 patients undergoing biologic treatment; only patients aged at least 18 years were included in this study. Patients completed the DLQI and HiSQOL. Construct validity was assessed by Pearson's correlation between DLQI and HiSQOL scores. The HiSQOL item discrimination was assessed by comparing differences in item responses between the highest and lowest 25% of HiSQOL scores. Multivariable linear regressions assessed relationships between individual PROM item responses and the total score of the other PROM.
In total, 677 patients [mean (SD) age 34.3 (11.3) years; 57.3% female (n = 388/677)] completed both the HiSQOL and DLQI. There was strong correlation between HiSQOL and DLQI total scores (Pearson's correlation coefficient 0.87, 95% confidence interval 0.85-0.89; P < 0.001). The HiSQOL items that had the biggest impact on QoL were related to 'embarrassment', 'depression' and 'anxiety'; items that also had the lowest relationships with total DLQI score.
The HiSQOL is a valid tool for assessing QoL in patients with HS in a real-world setting. Furthermore, the HiSQOL better captures aspects of HS that have the highest impact on QoL, including depression and anxiety, which are not captured by the DLQI.
Garg A
，Burge R
，Cohee A
，Wallinger H
，Truman I
，Keal A
，Strunk A
，Barlow S
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Pediatric-onset hidradenitis suppurativa: a case series of 42 patients.
Hidradenitis suppurativa is a chronic, recurring skin condition characterized by inflammation of the terminal hair follicle. It presents as painful, deep-seated, inflamed lesions such as nodules, fistulas, and abscesses. While the mean onset age for hidradenitis suppurativa is typically between 21 and 29 years, the condition can also manifest in childhood.
To review the clinical and demographic characteristics of pediatric-onset hidradenitis suppurativa patients.
We present a case series of 42 patients with pediatric-onset hidradenitis suppurativa (onset age 0-18 years) and their management from two tertiary referral centres. Demographic, clinical, and laboratory data were assessed at the Department of Dermatology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland, and the Department of Dermatology, Venereology, and Allergology, Medical University of Gdansk, Poland, from January 2000 to May 2023. This report details the epidemiology, clinical course, and management of the reported pediatric-onset hidradenitis suppurativa cases.
The median age of onset in our patients was 14 years (range: 5-17). The cohort comprised 20 (48%) males and 22 (52%) females. The most frequent lesion locations were in the inguinal folds and armpits, with additional occurrences in the buttocks and lower abdomen. Common comorbidities included obesity, hypothyroidism, and affective disorders. The treatment regimen for most patients involved topical clindamycin, systemic antibiotics, oral retinoids, and surgical excisions. Additionally, biologic treatments such as adalimumab, infliximab, and secukinumab were administered.
This study affirms that the clinical course and treatment methods in patients with pediatric-onset hidradenitis suppurativa are similar to the adult-onset form. Improved disease awareness enables earlier diagnosis, preventing the deterioration of skin lesions, a decrease in quality of life, and the onset of comorbidities, especially affective disorders, which are prevalent among patients with hidradenitis suppurativa.
Górecka A
，Barańska-Rybak W
，Lewandowski M
，Szymańska E
，Świerczewska Z
，Walecka I
... -
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Efficacy and safety of radiofrequency in the treatment of hidradenitis suppurativa; a systematic review.
Hidradenitis suppurativa (HS) is an inflammatory skin disease affecting apocrine gland-bearing sites of the body. Radiofrequency (RF) is a minimally invasive method that acts by minimizing thermal damage to the dermis, resulting in collagen synthesis and scar improvement. We systematically reviewed the efficacy and safety of RF in treating HS.
A systematic search was performed up to November 18th, 2023, in PubMed/Medline, Ovid Embase, and Web of Science. Clinical studies with English full texts were included. The National Institute of Health (NIH) Quality Assessment Tool for clinical trials and Methodological quality and synthesis of case series and case reports by Murad et al. were utilized for critical appraisal.
Out of 55 identified studies, 11 met our inclusion criteria with 167 subjects who underwent RF therapy alone or combined with an intense pulsed laser (IPL), known as LAight®. LAight® significantly improved clinical outcomes in mild-to-moderate HS patients based on the Dermatology Life Quality Index (DLQI), International Hidradenitis Suppurativa Score System (IHS4), Pain-Numerical Rating Scale (NRS), and Hidradenitis Suppurativa Clinical Response (HiSCR). Moreover, RF therapy alone significantly alleviated the clinical manifestations in patients with mild-to-moderate HS. Additionally, fractional microneedling RF significantly decreased HS-associated inflammatory markers. RF was found to be safe with limited adverse events. However, in moderate-to-severe HS, RF has failed to yield satisfactory results.
RF is a safe energy-based method with promising outcomes, especially for long-term application in mild-to-moderate HS. In moderate-to-severe cases, RF should be combined with a systemic medication for further beneficial impacts.
Nilforoushzadeh MA
，Heidari N
，Heidari A
，Ghane Y
，Hosseini S
，Lotfi Z
，Jaffary F
，Nobari MN
，Aghamiri ZS
，Nobari NN
... -
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Impact of antiviral prophylaxis on EBV viremia and posttransplant lymphoproliferative disorders in solid organ transplant recipients: a systematic review and meta-analysis.
Organ transplant recipients face a substantial risk of developing posttransplant lymphoproliferative disorders (PTLD). In over 90% of cases with B-cell PTLD following solid organ transplantation, the Epstein-Barr virus (EBV) genome is promptly identified, usually within the initial year. A continuing discussion revolves around the efficacy of antiviral prophylaxis in mitigating the incidence of PTLD in solid organ transplant (SOT) patients. This study aimed to conduct a systematic review and meta-analysis to investigate this issue.
A comprehensive search was conducted up to December 31, 2023, in databases including PubMed, Embase, and the Cochrane Library for retrospective and prospective studies comparing antiviral prophylaxis effects on EVB viremia and PTLD incidence in SOT recipients. Fixed or random effect models were applied based on the heterogeneity assessed via the I2 statistic, using Stata 16.0 software for data analysis.
In total, 22 eligible studies involving 13,498 patients were analyzed. Antiviral prophylaxis was associated with a significant reduction in EBV viremia incidence in SOT recipients, as demonstrated in 10 studies (relative risk (RR) 0.69, 95% CI 0.54 to 0.88). The rate of PTLD was significantly lower among those who received antiviral prophylaxis compared to those who did not, as reported in 18 studies (RR 0.77, 95% CI 0.63 to 0.94). No significant difference was observed in the subgroup of high-risk recipients based on EBV serology (RR 1.13, 95% CI 0.72 to 1.78). Additionally, a notable reduction in PTLD incidence was seen in the pediatric subgroup (RR 0.58, 95% CI 0.43 to 0.79) using antiviral prophylaxis, while no significant differences were observed in the subgroup of adults (RR 0.88, 95% CI 0.64 to 1.21). Administration of antiviral prophylaxis can significantly reduce the incidence of PTLD among kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart transplant patients (RR 0.61, 95% CI 0.39 to 0.96). PTLD incidence was significantly reduced among recipients of T-cell depletion or steroid-based immunosuppression using antiviral prophylaxis (RR 0.54, 95% CI 0.39-0.74 and RR 0.55, 95% CI 0.41-0.73, respectively).
This meta-analysis revealed that administering antiviral prophylaxis to patients after solid organ transplantation reduces PTLD and EBV viremia occurrences, especially among pediatric recipients, individuals undergoing kidney or heart transplantation, and those receiving high-intensity immunosuppression regimens. Post-transplant lymphoproliferative disorders (PTLD) and other EBV syndromes are among the most serious complications following solid organ transplantation (SOT), primarily due to the necessity for prolonged immunosuppressive therapy. Among the strategies for preventing EBV-related complications, the use of antiviral prophylaxis is a subject of ongoing debate. This systematic review and meta-analysis found that antiviral prophylaxis significantly reduced EBV viremia incidence (risk ratio (RR) 0.69, 95% confidence interval (CI) 0.54 to 0.88) compared to those without prophylaxis. In the sub-analysis related to high-risk EBV serologically mismatched SOT recipients (EBV D+/R-), the result did not show a significant difference in terms of PTLD incidence (RR 1.13, 95% CI 0.72 to 1.78). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among pediatric SOT patients (RR 0.58, 95% CI 0.43 to 0.79), but not among adult patients (RR 0.88, 95% CI 0.64 to 1.21). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among kidney/simultaneous pancreas and kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart (RR 0.61, 95% CI 0.39 to 0.96) transplant patients but not liver (RR 0.5, 95% CI 0.23 to 1.08) transplant recipients.
Moghadamnia M
，Delroba K
，Heidari S
，Rezaie Z
，Dashti-Khavidaki S
... -
《Virology Journal》
ResearchGate
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