Pain in Hidradenitis Suppurativa: A Pilot Study

Hidradenitis suppurativa (HS) is a chronic, inflammatory and often painful, skin disease presenting as recurrent nodules and tunnels (sinus tracts) with subsequent scarring predominantly involving the intertriginous regions. The nodules progress from non-inflamed, through inflamed nodules, to abscesses that may rupture causing suppuration and severe malodorous discharge (1). Estimates of the prevalence of HS range from 0.05% to 4% (2). Although it has been shown that the hair follicle is central to the pathogenesis of the disease the exact aetiology of HS is unknown (3, 4). Adjuvant measures may alleviate the symptoms; however, many patients require surgery to manage chronic predisposing anatomical changes. Pain is an important aspect of HS. Several studies have previously demonstrated a significant reduction in quality of life (QoL), using Dermatology Life Quality Index (DLQI), among patients with HS (5, 6). In fact, a study found that the mean DLQI scores for patients with HS (8.9) were higher than previously reported for other skin diseases, such as alopecia (8.3), acne (7.5) and psoriasis (7.0) (6). The highest DLQI scores attained were predominantly attributed to soreness, embarrassment and level of HS-related pain, highlighting the role of HS-related pain in the everyday life of patients with HS. The body of literature describing HS-related pain is small. Increased understanding of HS-related pain would aid dermatologists and other physicians in managing all aspects of HS, from the perspectives of both patients and physicians.