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Delay in HS diagnosis observed

There appears to be a delay in the diagnosis of patients with hidradenitis suppurativa (HS), according to researchers who reported findings of a Canadian epidemiological multicenter, cross-sectional retrospective study.

This study, published in the Journal of Cutaneous Medicine and Surgery (Jan. 2016; 20(1):52–57), was discussed by senior author Dr. Afsaneh Alavi during a joint presentation with Dr. Melinda Gooderham at the fall 2015 sessions of Dermatology Update in Toronto.

“HS is a chronic, debilitating, recurrent condition with deep seated inflammatory lesions that can result in some pretty horrific scarring,” said Dr. Gooderham, who is medical director of the Skin Centre for Dermatology based in Peterborough, Ont.

“We are unsure about the exact prevalence of HS, but it is estimated that in Canada there are about 350,000 to one million people who have HS,” said Dr. Alavi, a Toronto based dermatologist and assistant professor, Department of Medicine (Dermatology), University of Toronto.

Data from a cohort study that compared HS and psoriasis patients showed that HS patients have a doubled rate of hospitalization and an overall higher use of the emergency department (27% for patients with HS and 17% for psoriasis), noted Dr. Alavi.

“Unfortunately, patients with HS often suffer in silence and are tossed back and forth between primary care physicians and the emergency department. The delay in the diagnosis and management of HS leaves physical and psychological sequela in this patient population,” said Dr. Alavi.

Delayed diagnosis

The objective of the study published in the Journal of Cutaneous Medicine and Surgery was to review demographic features and clinical findings among 80 patients with hidradenitis suppurativa from two referral centres in Ontario from Oct. 2013 to Sept. 2014.

During the study investigators also aimed to assess factors that could be associated with more advanced disease. Findings from the cross-sectional retrospective study revealed that 67.5% of the 80 HS patients were female, 46.3% were younger than 35 years, and 75% of the HS patients identified themselves as Caucasian.

The authors reported that slightly less than half of patients (45%) consumed alcohol and 64.1% were smokers or former smokers. Many of the participants had coexisting metabolic disorders—42.3% had a body mass index >30, 25.6% of the HS patients had diabetes and 16.3% had hypertension.

“As we expected, a majority of the 80 patients’ HS was at Hurley stage II or III,” said Dr. Alavi.

“What was interesting was that more than 40 per cent of the participants did not receive a diagnosis in the first five years after the initial presentation, and 56 per cent were diagnosed by dermatologists.”

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