Hidradenitis suppurativa in surgeons' practice: Prevalence and treatment approach according to the Hurley stage in Latvia

Dermatol Ther. 2021 Jan;34(1):e14687. doi: 10.1111/dth.14687. Epub 2020 Dec 23.

Abstract

Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating, and frequently misdiagnosed inflammatory skin disease that often requires surgical intervention. To assess the prevalence of HS patients in surgeons' practice and surgeons' approach to treating HS patients, we created a self-administered, Hurley stage-based questionnaire that was distributed during the Latvian Association of Surgeons meeting. Of the total 60 questionnaires distributed, 56 (93%) were collected and 53 (88%) of them were considered valid. Overall, 73.6% of the surgeons confirmed having seen patients with chronic inflamed suppurative lesions in the skin folds during their practice. Median reported number of HS patients in the surgeons' practice was 3, ranging from 0 to 30. Similarly, 73.6% of surgeons would undertake HS treatment. The proportion of surgeons undertaking treatment was higher if the surgeons had diagnosed HS by themselves but was not affected by personal knowledge of HS. Surgeons chose monotherapy for Hurley stages I, II, and III in 64.2%, 64.2%, and 62.3% of the cases, respectively. The most common therapeutic choice for monotherapy was topical antiseptics (26.4%) or topical antibiotics (20.8%) for Hurley stage I and surgery or systemic antibiotics for Hurley stage II (20.8% or 17.0%, respectively) and Hurley stage III (32.1% or 11.3%, respectively). A wide diversity of treatment approaches in specified clinical scenarios was observed, which indicates the need for local guidelines.

Keywords: experience; hidradenitis suppurativa; knowledge; multidisciplinary team; surgery.

MeSH terms

  • Hidradenitis Suppurativa* / diagnosis
  • Hidradenitis Suppurativa* / drug therapy
  • Hidradenitis Suppurativa* / epidemiology
  • Humans
  • Latvia / epidemiology
  • Prevalence
  • Severity of Illness Index
  • Surgeons*