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Muñoz-Barba D, Haselgruber de Francisco S, León-Pérez FJ, Cuenca-Barrales C, Arias-Santiago S, Sánchez-Díaz M, Molina-Leyva A. Severity and Therapeutic Decisions Based on Lesion Location in Patients With Hidradenitis Suppurativa. Int J Dermatol 2025. [PMID: 40391700 DOI: 10.1111/ijd.17861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Revised: 02/19/2025] [Accepted: 05/09/2025] [Indexed: 05/22/2025]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease for which several phenotypic classifications have been proposed in recent years to optimize medical care. The aim of this study was to define a new classification of HS based on the anatomical distribution of lesions, serving as a tool for therapeutic decision-making. METHODS This cross-sectional study with consecutive sampling included patients attending their first medical consultation at the Hidradenitis Suppurativa Unit of Virgen de las Nieves University Hospital in Granada, Spain, between January 1, 2017, and March 1, 2024. Patients were classified into four groups based on the anatomical distribution of HS: Upper, Atypical, Lower, and Progressor HS. Sociodemographic variables, personal history, and HS-related variables were collected. RESULTS A total of 557 patients were included, with a similar proportion of men and women. Patients with the Upper type exhibited milder forms of HS and underwent surgical treatment more frequently. In contrast, those with the Progressor type presented more severe forms of HS and required more immunomodulatory treatment. Patients in the Atypical and Lower groups showed more heterogeneity in therapeutic approaches, although the presence of lesions in specific locations may help predict the need for early initiation of more aggressive treatments. CONCLUSIONS We propose a new HS classification based on the location of lesions. This classification can be used alone or in conjunction with previous ones to identify patients at higher risk of progression and to guide therapeutic decision-making.
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Affiliation(s)
- Daniel Muñoz-Barba
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
| | | | | | - Carlos Cuenca-Barrales
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, Granada, Spain
| | - Manuel Sánchez-Díaz
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, Granada, Spain
| | - Alejandro Molina-Leyva
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
- Instituto de Investigación Biosanitaria, Granada, Spain
- Dermatology Department, School of Medicine, University of Granada, Granada, Spain
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2
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Carnero González L, Garcias-Ladaria JG, Rivera-Díaz R, Bassas Vila J, Salgado-Boquete L, Masferrer E, Molina-Leyva A, Perandones-González H, Muñiz de Lucas A, Pascual JC, Mendieta-Eckert M, Martín-Ezquerra G, Garbayo-Salmons P, Nieto-Benito LM, Romaní J, Escutia B, Herrera-Acosta E, Vilarrasa E, Luque-Luna M, Pericet Fernández LM, Rodríguez García F, No Pérez N, Gracia-Darder I, Falkenhain-López D, Mora-Fernández V, Oro-Ayude M, Corral-Magaña O, Grau-Pérez M, Martorell A. [Translated article] Spanish Hidradenitis Suppurativa Registry (REHS) of the Spanish Academy of Dermatology and Venereology: Description and Data From its First Year of Operation. ACTAS DERMO-SIFILIOGRAFICAS 2025:S0001-7310(25)00214-5. [PMID: 40174770 DOI: 10.1016/j.ad.2025.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 12/27/2024] [Accepted: 12/31/2024] [Indexed: 04/04/2025] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a skin disease that significantly impacts patients' quality of life. There are still uncertainties surrounding its epidemiology, natural history, and the safety and effectiveness of existing treatments. The Spanish Academy of Dermatology and Venereology has promoted the creation of a Spanish Registry of patients with HS (REHS). The aim of this article is to present the REHS and provide the initial results obtained. METHODS The REHS is a prospective, multicenter, observational study that collects the clinical and epidemiological characteristics of patients with HS, as well as the safety and effectiveness of the medical and surgical treatments received. RESULTS Between June 2023 and June 2024, 359 patients were recruited from 23 Spanish centers. The average age of the patients is 37 years, and 53% of them are women. Over 70% of the patients are smokers or former smokers. One third have a family history of HS. The most frequent sites of disease onset are the axillae and groin. Median baseline IHS4 at recruitment was 4 (p25-p75=1-9), HiSQOL was 20 (p25-p75=8-36), and BMI was 27.3 (p25-p75=24-33.2). At least 82% of patients have received antibiotic therapy for their disease, and almost 20% a biologic drug. CONCLUSIONS We present data from the first patients enrolled in the REHS, which will allow for the generation of evidence on the natural course of the disease, as well as the effectiveness and safety of treatments in HS.
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Affiliation(s)
- L Carnero González
- Servicio de Dermatología, Hospital Universitario Araba, Vitoria, Vizcaya, Spain
| | - J G Garcias-Ladaria
- Servicio de Dermatología, Hospital Universitario Son Espases, Palma, Mallorca, Spain
| | - R Rivera-Díaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | - J Bassas Vila
- Servicio de Dermatología, Hospital Universitari Germans Trías i Pujol, Badalona, Barcelona, Spain
| | - L Salgado-Boquete
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - E Masferrer
- Servicio de Dermatología, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, Spain; Universidad de Vic, Universidad Central de Cataluña, Barcelona, Spain
| | - A Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - A Muñiz de Lucas
- Servicio de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - J C Pascual
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - M Mendieta-Eckert
- Servicio de Dermatología, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | | | - P Garbayo-Salmons
- Servicio de Dermatología, Parc Taulí Hospital Universitari, Sabadell, Barcelona, Spain
| | - L M Nieto-Benito
- Servicio de Dermatología, Clínica Universidad de Navarra, Madrid, Spain
| | - J Romaní
- Servicio de Dermatología, Hospital General de Granollers, Granollers, Barcelona, Spain
| | - B Escutia
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - E Herrera-Acosta
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - E Vilarrasa
- Servicio de Dermatología, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic, Barcelona, Spain
| | - L M Pericet Fernández
- Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - F Rodríguez García
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, Spain
| | - N No Pérez
- Servicio de Dermatología, Hospital do Meixoeiro, Vigo, Pontevedra, Spain
| | - I Gracia-Darder
- Servicio de Dermatología, Hospital Universitario Son Espases, Palma, Mallorca, Spain
| | - D Falkenhain-López
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - V Mora-Fernández
- Servicio de Dermatología, Hospital Universitari Germans Trías i Pujol, Badalona, Barcelona, Spain
| | - M Oro-Ayude
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - O Corral-Magaña
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - M Grau-Pérez
- Unidad de Investigación de la Academia Española de Dermatología y Venereología, Madrid, Spain.
| | - A Martorell
- Servicio de Dermatología, Hospital de Manises, Manises, Valencia, Spain
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Aguado Vázquez A, Díaz Corpas T, García Ruíz R, Mateu Puchades A. Clinical and Demographic Characteristics of Patients Diagnosed with Hidradenitis Suppurativa During the Childhood and Adolescence. A 28-Patient Retrospective Observational Study. ACTAS DERMO-SIFILIOGRAFICAS 2025:S0001-7310(25)00124-3. [PMID: 40073968 DOI: 10.1016/j.ad.2024.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 11/27/2024] [Accepted: 12/01/2024] [Indexed: 03/14/2025] Open
Affiliation(s)
- A Aguado Vázquez
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España.
| | - T Díaz Corpas
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España
| | - R García Ruíz
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España
| | - A Mateu Puchades
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España
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Luo H, Chen Y, Li J, Yang Y, Wang X, Yang P, Guo C, Liu F. Inflammatory proteins and hidradenitis suppurativa: Insights from genetic correlation and Mendelian randomization. J Dermatol 2025; 52:481-492. [PMID: 39704160 DOI: 10.1111/1346-8138.17590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 10/19/2024] [Accepted: 12/03/2024] [Indexed: 12/21/2024]
Abstract
Previous research has highlighted a significant association between inflammatory proteins and the development and progression of hidradenitis suppurativa (HS). Nevertheless, the potential causative link between these factors remains to be definitively established. To investigate the genetic correlation between inflammatory proteins and HS, linkage disequilibrium score regression (LDSC) was employed. Mendelian randomization (MR) analysis, incorporating inverse variance weighted, MR-Egger, and weighted median methodologies, was utilized to evaluate the possible causal relationship between circulating inflammatory proteins (CIPs) and HS. Additionally, reverse MR analysis was carried out to explore reverse causality. The data set for 91 CIPs was derived from a genome-wide protein quantitative trait loci study, while HS-related data were acquired from the FinnGen study. Moreover, the stability of the causal relationships was assessed via sensitivity analyses, encompassing tests for pleiotropy, heterogeneity, and leave-one-out analysis. The LDSC analysis suggested the existence of genetic correlations between the levels of Fibroblast growth factor 21 (FGF-21), stem cell factor, and HS. The MR analysis identified a suggestive association of T-cell surface glycoprotein CD5 and C-X-C motif chemokine 11 with an elevated risk of HS. Conversely, C-C motif chemokine 4, Protein S100-A12, Interleukin-10 receptor subunit beta, and Programmed cell death 1 ligand 1 were associated with a diminished risk of HS. Moreover, HS was demonstrated to increase the levels of four CIPs: Interleukin-20, Leukemia inhibitory factor (LIF), LIF receptor, and Thymic stromal lymphopoietin. The findings of this investigation offer suggestive evidence for possible genetic correlations and causal links between various genetically predicted inflammatory proteins and HS. There exists a pressing requirement for additional studies to elucidate the fundamental processes driving these associations.
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Affiliation(s)
- Hui Luo
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Yang Chen
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Jianrong Li
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Yanmei Yang
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Xiujun Wang
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Ping Yang
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Chuang Guo
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
| | - Fei Liu
- Department of Traditional Chinese Medicine, People's Hospital of Xiangyun County, Dali, China
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Haselgruber S, Muñoz‐Barba D, Leon‐Pérez FJ, Cuenca‐Barrales C, Arias‐Santiago S, Molina‐Leyva A. Therapeutic burden in hidradenitis suppurativa: a cross-sectional study of 557 patients. Int J Dermatol 2025; 64:539-545. [PMID: 39407357 PMCID: PMC11840222 DOI: 10.1111/ijd.17517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/23/2024] [Accepted: 09/28/2024] [Indexed: 02/21/2025]
Abstract
INTRODUCTION Therapeutic burden (TB) has been identified as a potential predictor of response to biologic therapy in hidradenitis suppurativa (HS). We aim to analyze the determinants of TB in real-world clinical settings among HS patients to explain this concept and its utility as an additional tool for guiding therapeutic decision-making. METHODS We conducted a cross-sectional study including all consecutive HS patients attending a specialized HS clinic between 2017 and 2024. The primary variable was TB, defined as the cumulative sum of prior systemic treatment cycles and surgical interventions for HS. We analyzed whether sociodemographic or clinical factors were associated with a higher TB. RESULTS We included 557 HS patients. Of these, 50.81% were women, and the mean age was 41.87 (14.19) years. Most patients (62.30%) were referred from general dermatology consultations. The mean disease duration was 17.52 (11.51) years. Regarding disease severity, 46.50% presented with Hurley II, and 42.19% had an IHS-4 score between 4 and 10. Before their baseline visit, 9.70% of patients had received biological therapy, mostly adalimumab (88.89%). The mean TB was 2.42 (2.25) systemic medical and/or surgical interventions. Referral from general dermatology or other hospital departments, older age, longer disease duration, greater HS severity, presence of pilonidal sinus, and prior biological therapy were significantly associated with higher TB. CONCLUSIONS Our findings suggest that TB comprehensively captures HS severity and progression factors. This metric could prove valuable in aiding decision-making for HS patients by indicating when a change in therapy might be necessary.
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Affiliation(s)
- Sofía Haselgruber
- Hospital Universitario Virgen de las NievesServicio de DermatologíaGranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- European Hidradenitis Suppurativa Foundation e.VDessauGermany
| | - Daniel Muñoz‐Barba
- Hospital Universitario Virgen de las NievesServicio de DermatologíaGranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
| | - Francisco Javier Leon‐Pérez
- Hospital Universitario Virgen de las NievesServicio de DermatologíaGranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
| | - Carlos Cuenca‐Barrales
- Hospital Universitario Virgen de las NievesServicio de DermatologíaGranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
| | - Salvador Arias‐Santiago
- Hospital Universitario Virgen de las NievesServicio de DermatologíaGranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- Facultad de MedicinaUniversidad de GranadaGranadaSpain
| | - Alejandro Molina‐Leyva
- Hospital Universitario Virgen de las NievesServicio de DermatologíaGranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- European Hidradenitis Suppurativa Foundation e.VDessauGermany
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Marzano AV, Bartoletti M, Bettoli V, Bianchi L, Chiricozzi A, Clerici M, Dapavo P, Dini V, Foti C, Magnoni C, Megna M, Micali G, Molinelli E, Prignano F. Hidradenitis suppurativa, from basic science to surgery and a new era of tailored targeted therapy: An expert opinion paper. Arch Dermatol Res 2025; 317:511. [PMID: 40021535 PMCID: PMC11870890 DOI: 10.1007/s00403-025-04016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 01/23/2025] [Accepted: 02/12/2025] [Indexed: 03/03/2025]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterised by an aberrant activation of innate immunity and increased production of pro-inflammatory mediators such as interleukin 17 (IL-17). IL-17 has been shown to play a key role in the pathogenesis of HS and evidence highlights the potential of IL-17-targeted therapies. The fully human IgG/κ monoclonal antibody secukinumab, which specifically targets IL-17A and inhibits interaction with its receptor, has recently been approved for the treatment of moderate-to-severe HS. Secukinumab offers patients an efficacious and well-tolerated treatment option in terms of sustained response by rapidly improving signs and symptoms, and preventing disease progression in the absence of loss of response. Being a challenging disease, HS is associated with a delay to diagnosis of 3-10 years and, consequently, late implementation of appropriate treatment, leading to disease progression. Misdiagnosis due to flawed understanding and lack of awareness among medical providers and patients is considered an important factor contributing to the delayed diagnosis. Thus, serious efforts must be made on a large scale to urgently reduce the delay in HS diagnosis and reduce the disease burden in patients, including raising awareness, implementation of education programmes at medical and specialisation schools, as well as continuous education of healthcare providers at different levels for the early detection of HS and initiation of appropriate treatment. Here, we present the main critical unmet needs in the diagnosis and treatment of patients affected by HS, address how disease awareness and comprehensive multidisciplinary management (offering both medical and surgical care) can benefit patients, and suggest therapeutic options, based on clinical characterisation and early identification and intervention (window of opportunity), to be adopted for a timely and better management of disease progression and to fill current gaps.
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Affiliation(s)
- Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Michele Bartoletti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Vincenzo Bettoli
- O.U. Of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Luca Bianchi
- Dermatology, Fondazione Policlinico Tor Vergata, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mario Clerici
- Università Degli Studi Di Milano, Milan, Italy
- Don C Gnocchi Foundation IRCCS, Milan, Italy
| | - Paolo Dapavo
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Cristina Magnoni
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Elisa Molinelli
- Department of Clinical and Molecular Science, Dermatologic Clinic, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Francesca Prignano
- Department of Health Sciences, Dermatology Section, Università degli Studi di Firenze, Florence, Italy
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Carnero González L, Garcias-Ladaria JG, Rivera-Díaz R, Bassas Vila J, Salgado-Boquete L, Masferrer E, Molina-Leyva A, Perandones-González H, Muñiz de Lucas A, Pascual JC, Mendieta-Eckert M, Martín-Ezquerra G, Garbayo-Salmons P, Nieto-Benito LM, Romaní J, Escutia B, Herrera-Acosta E, Vilarrasa E, Luque-Luna M, Pericet Fernández LM, Rodríguez García F, No Pérez N, Gracia-Darder I, Falkenhain-López D, Mora-Fernández V, Oro-Ayude M, Corral-Magaña O, Grau-Pérez M, Martorell A. Spanish Hidradenitis Suppurativa Registry (REHS) of the Spanish Academy of Dermatology and Venereology: description and data from its first year of operation. ACTAS DERMO-SIFILIOGRAFICAS 2025:S0001-7310(25)00097-3. [PMID: 39970984 DOI: 10.1016/j.ad.2024.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 12/27/2024] [Accepted: 12/31/2024] [Indexed: 02/21/2025] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a skin disease that significantly impacts patients' quality of life. There are still uncertainties surrounding its epidemiology, natural history, and the safety and effectiveness of existing treatments. The Spanish Academy of Dermatology and Venereology has promoted the creation of a Spanish Registry of patients with HS (REHS). The aim of this article is to present the REHS and provide the initial results obtained. METHODS The REHS is a prospective, multicenter, observational study that collects the clinical and epidemiological characteristics of patients with HS, as well as the safety and effectiveness of the medical and surgical treatments received. RESULTS Between June 2023 and June 2024, 359 patients were recruited from 23 Spanish centers. The average age of the patients is 37 years, and 53% of them are women. Over 70% of the patients are smokers or former smokers. One third have a family history of HS. The most frequent sites of disease onset are the axillae and groin. Median baseline IHS4 at recruitment was 4 (p25-p75=1-9), HiSQOL was 20 (p25-p75=8-36), and BMI was 27.3 (p25-p75=24-33.2). At least 82% of patients have received antibiotic therapy for their disease, and almost 20% a biologic drug. CONCLUSIONS We present data from the first patients enrolled in the REHS, which will allow for the generation of evidence on the natural course of the disease, as well as the effectiveness and safety of treatments in HS.
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Affiliation(s)
- L Carnero González
- Servicio de Dermatología, Hospital Universitario Araba, Vitoria, Vizcaya, España
| | - J G Garcias-Ladaria
- Servicio de Dermatología, Hospital Universitario Son Espases, Palma, Mallorca, España
| | - R Rivera-Díaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España; Universidad Complutense de Madrid, Madrid, España
| | - J Bassas Vila
- Servicio de Dermatología, Hospital Universitari Germans Trías i Pujol, Badalona, Barcelona, España
| | - L Salgado-Boquete
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - E Masferrer
- Servicio de Dermatología, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España; Universidad de Vic, Universidad Central de Cataluña, Barcelona, España
| | - A Molina-Leyva
- Servicio de Dermatología. Hospital Universitario Virgen de las Nieves, Granada, España
| | | | - A Muñiz de Lucas
- Servicio de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España
| | - J C Pascual
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - M Mendieta-Eckert
- Servicio de Dermatología, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España
| | | | - P Garbayo-Salmons
- Servicio de Dermatología, Parc Taulí Hospital Universitari, Sabadell, Barcelona, España
| | - L M Nieto-Benito
- Servicio de Dermatología, Clínica Universidad de Navarra, Madrid, España
| | - J Romaní
- Servicio de Dermatología, Hospital General de Granollers, Granollers, Barcelona, España
| | - B Escutia
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - E Herrera-Acosta
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - E Vilarrasa
- Servicio de Dermatología, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, España
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic, Barcelona, España
| | - L M Pericet Fernández
- Servicio de Dermatología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - F Rodríguez García
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España
| | - N No Pérez
- Servicio de Dermatología, Hospital do Meixoeiro, Vigo, Pontevedra, España
| | - I Gracia-Darder
- Servicio de Dermatología, Hospital Universitario Son Espases, Palma, Mallorca, España
| | - D Falkenhain-López
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - V Mora-Fernández
- Servicio de Dermatología, Hospital Universitari Germans Trías i Pujol, Badalona, Barcelona, España
| | - M Oro-Ayude
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - O Corral-Magaña
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - M Grau-Pérez
- Unidad de Investigación de la Academia Española de Dermatología y Venereología, Madrid, España.
| | - A Martorell
- Servicio de Dermatología, Hospital de Manises, Manises, Valencia, España
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Haselgruber S, Fernández-Crehuet-Serrano P, Fernández-Ballesteros MD, Padial-Gómez A, Hernández-Rodríguez JC, Ortiz-Álvarez J, Navarro-Guillamón P, Membrive-Jiménez C, Cuenca-Barrales C, Molina-Leyva A. Insights into the Window of Opportunity and Outcome Measures in Patients with Moderate to Severe Hidradenitis Suppurativa Treated with Secukinumab: A Real-World Study. Dermatol Ther (Heidelb) 2024; 14:1875-1890. [PMID: 38896382 PMCID: PMC11264522 DOI: 10.1007/s13555-024-01209-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCION The concept of a window of opportunity in hidradenitis suppurativa (HS) management suggests that early initiation of biological therapy leads to better outcomes, though its timing remains uncertain. METHODS We conducted a retrospective observational multicenter study, including consecutive patients with moderate to severe HS who initiated secukinumab treatment following prior failure with systemic antibiotics or adalimumab. Therapeutic burden was defined as the sum of previous systemic treatment cycles and previous major surgical interventions for HS. Patients were followed up for 24 weeks. Main outcomes were safety and effectiveness, assessed through the proportion of patients achieving HS Clinical Response (HiSCR) and a 55% reduction in International HS Severity Score System (IHS4-55). Additionally, potential predictors of response to secukinumab were studied. Analysis was performed on an intention-to-treat basis. RESULTS A total of 67 patients (33 men, 34 women) were included, with a mean age of 41.55 (11.94) years and a mean baseline IHS4 of 17.88 (11.13). The mean therapeutic burden was 6.06 (3.49). At week 24, 10.45% (7/67) of patients experienced adverse events, with three leading to treatment discontinuation. At week 24, 41.79% (28/67) of patients achieved HiSCR, and 44.78% (30/67) of patients achieved IHS4-55. HiSCR could not be calculated in 12 patients with a baseline AN count < 3. A lower therapeutic burden was significantly associated with a higher likelihood of achieving HiSCR and IHS4-55 at week 24. CONCLUSIONS Secukinumab showed safety and efficacy in real-world patients with HS, and the inverse correlation found between therapeutic burden and treatment response supports the concept of a window of opportunity, offering insights into its timing.
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Affiliation(s)
- Sofía Haselgruber
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | | | | | - Alicia Padial-Gómez
- Servicio de Dermatología, Hospital Universitario de Jerez de la Frontera, Cádiz, Spain
| | | | - Juan Ortiz-Álvarez
- Servicio de Dermatología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | - Cristina Membrive-Jiménez
- Departamento de Bioquímica y Biología Molecular II, Universidad de Granada, Granada, Spain
- Unidad de Farmacogenética, Servicio de Farmacia Hospitalaria, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Carlos Cuenca-Barrales
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Alejandro Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
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Katoulis A, Efthymiou O, Liakou A, Pappa G, Kanelleas A, Koumaki D, Bozi E, Sgouros D. Resorcinol 10% as a Promising Therapeutic Option for Mild Hidradenitis Suppurativa: A Prospective, Randomized, Open Study. Skin Appendage Disord 2023; 9:438-443. [PMID: 38058541 PMCID: PMC10697770 DOI: 10.1159/000531926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/16/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Treatment of hidradenitis suppurativa (HS) is challenging, and in Hurley stage I, it is based on topical measures. Our aim was to compare the efficacy and safety of topical resorcinol 10% with topical clindamycin 1% and no therapy, in Hurley stage I HS. Methods In this open, prospective, randomized trial, we studied 60 Hurley stage I patients with IHS4 ≤10. Group A was treated with topical resorcinol 10%; group B with clindamycin lotion 1%; and group C received no treatment. Patients were evaluated by total lesion count, the International Hidradenitis Suppurativa Severity Score System (IHS4) and the Dermatology Life Quality Index (DLQI) at baseline, 12 and 24 weeks. Self-reported number of flares and adverse events (AEs) were recorded. Results A significant reduction in the mean total lesion count and DLQI scores were observed in group A, compared to group B at week 12 (p = 0.036, p < 0.001, respectively), and in the mean total lesion count, IHS4, and DLQI scores at week 24 (p = 0.034, p = 0.017, p < 0.001, respectively). Resorcinol 10% was well-tolerated with only mild AEs. Conclusion Resorcinol 10% may represent a useful alternative for the long-term treatment of mild HS, which is superior to topical clindamycin and has a favorable safety profile.
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Affiliation(s)
- Alexander Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Ourania Efthymiou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Aikaterini Liakou
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School, "Andreas Sygros" Hospital for Cutaneous and Venereal Diseases, Athens, Greece
| | - Georgia Pappa
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Antonios Kanelleas
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, Heraklion, Greece
| | - Evangelia Bozi
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
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