Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity

Background: Few comprehensive studies exist on the epidemiology of hidradenitis suppurativa, a very distressing skin disease.

Objective: We sought to identify disease-related factors associated with severity, sex, and family history.

Methods: Ordinal logistic regression was used in 846 consecutive Dutch patients with hidradenitis suppurativa to calculate odds ratios (ORs) for severity according to Hurley. Sex and family history were compared using Student t test and χ(2) test.

Results: In total, 45.5% of the patients had Hurley I, 41.5% had Hurley II, and 13.0% had Hurley III. Severity was associated with male sex (OR 2.11; P < .001), disease duration (OR 1.03; P < .001), body mass index (OR 1.03; P = .01), smoking pack-years (OR 1.02; P = .001), and axillary (OR 2.24; P < .001), perianal (OR 1.92; P < .001), and mammary lesions (OR 1.48; P = .03). Women had earlier onset, more inguinal and mammary lesions, and more frequent family history for hidradenitis suppurativa. Men more commonly had gluteal, perianal, and atypical lesions, and a history of severe acne. Patients with a family history had earlier onset, longer disease duration, a history of severe acne, more extensive disease, and were more often smokers.

Limitations: Some parameters were patient-reported.

Conclusion: The severity risk factors identified in this study could help physicians to select patients who need close monitoring and who would benefit from early, aggressive therapy.