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Özkur E, Karadağ AS, Üstüner P, Aksoy B, Eşme P, Çalışkan E, Akoğlu G, Kalkan G, Demirseren DD, Polat M, Ozden MG, Kılınç F, Yalçınkaya İyidal A, Kıvanç Altunay İ, Türkmen M, Uğurer E, Baysak S, Fettahlıoğlu Karaman B, Mammadlı K, Baykal Selçuk L, Türkoğlu Z, Atcı T, Didar Balcı D, Adışen E, Temel B, Aktan Ş, Kaçar N, Gündüz K, Türel Ermertcan A, Özdemir M, Ünal Çakıter A, Çölgeçen E, Uçmak D, Kelekçi H, Ataseven A, Durmaz K, Kaya Özden H, Engin B, Yazıcı S, Alpsoy E. Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity. Clin Exp Dermatol 2021; 46:532-540. [PMID: 33030217 DOI: 10.1111/ced.14478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. AIM In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. METHODS In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. RESULTS The mean age of disease onset was 26.2 ± 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 ± 8.4 years with a delay in diagnosis of 5.8 ± 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. CONCLUSIONS Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity.
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Affiliation(s)
- E Özkur
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - A S Karadağ
- Department of Dermatology, Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey
| | - P Üstüner
- Department of Dermatology, Demiroğlu Bilim University, Faculty of Medicine, Istanbul, Turkey
| | - B Aksoy
- Department of Dermatology, Bahcesehir University, Faculty of Medicine, Istanbul, Turkey.,VM Medical Park Kocaeli Hospital, Kocaeli, Turkey
| | - P Eşme
- Department of Dermatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - E Çalışkan
- Department of Dermatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - G Akoğlu
- Department of Dermatology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - G Kalkan
- Department of Dermatology, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey
| | - D D Demirseren
- Department of Dermatology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - M Polat
- Department of Dermatology, Bolu Abant İzzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - M G Ozden
- Department of Dermatology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
| | - F Kılınç
- Department of Dermatology, Bolu Abant İzzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - A Yalçınkaya İyidal
- Department of Dermatology, Keçiören Training and Research Hospital, Ankara, Turkey
| | - İ Kıvanç Altunay
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - M Türkmen
- Department of Dermatology, İzmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - E Uğurer
- Department of Dermatology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - S Baysak
- Department of Dermatology, Sultan Abdülhamit Han Training and Research Hospital, Istanbul, Turkey
| | | | - K Mammadlı
- Department of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - L Baykal Selçuk
- Department of Dermatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Z Türkoğlu
- Department of Dermatology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - T Atcı
- Department of Dermatology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - D Didar Balcı
- Department of Dermatology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - E Adışen
- Department of Dermatology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - B Temel
- Department of Dermatology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Ş Aktan
- Department of Dermatology, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - N Kaçar
- Department of Dermatology, Pamukkale University, Faculty of Medicine, Denizli, Turkey
| | - K Gündüz
- Department of Dermatology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - A Türel Ermertcan
- Department of Dermatology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - M Özdemir
- Department of Dermatology, Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - A Ünal Çakıter
- Department of Dermatology, Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - E Çölgeçen
- Department of Dermatology, Yozgat Bozok University, Faculty of Medicine, Yozgat, Turkey
| | - D Uçmak
- Department of Dermatology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - H Kelekçi
- Department of Dermatology, Izmir Katip Celebi University, Faculty of Medicine, Izmır, Turkey
| | - A Ataseven
- Department of Dermatology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - K Durmaz
- Department of Dermatology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - H Kaya Özden
- Department of Dermatology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - B Engin
- Department of Dermatology, Istanbul University, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - S Yazıcı
- Department of Dermatology, Uludağ University, Faculty of Medicine, Bursa, Turkey
| | - E Alpsoy
- Department of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Emre S, Metin A, Demirseren DD, Kilic S, Isikoglu S, Erel O. The relationship between oxidative stress, smoking and the clinical severity of psoriasis. J Eur Acad Dermatol Venereol 2012; 27:e370-5. [PMID: 23004342 DOI: 10.1111/j.1468-3083.2012.04700.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recent studies suggested that increased oxidant products and decreased antioxidant system functions may be involved in the pathogenesis of psoriasis. In this study, we investigated total oxidative status, Paraoxonase (PON)1/arylesterase enzyme activities and severity of the disease in smoker and non-smoker psoriatic patients. METHODS Fifty-four patients with plaque type psoriasis (28 smokers and 26 non-smokers) and 62 healthy volunteers (16 smokers and 46 non-smokers) were enrolled in the study. Serum total oxidant status (TOS), total antioxidant capacity (TAC) and arylesterase levels were measured, and oxidative stress index (OSI) was calculated in all participants. RESULTS Psoriasis Area and Severity Index scores were significantly higher in smoker patients than in non-smoker patients (P = 0.014). Both smoker and non-smoker patients had significantly increased TOS levels and OSI values and decreased TAC levels than healthy subjects (all P values = 0.000). The TAC and TOS levels, OSI values and arylesterase activities were similar between smoker and non-smoker patients. The levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were not significantly different between smoker and non-smoker psoriasis patients. When compared with non-smoking controls, only smoking psoriasis patients had significantly higher TG (P = 0.005), lower HDL (P = 0.022) and lower arylesterase levels (P = 0.015). There were no significant correlations with Psoriasis Area and Severity Index (PASI) scores and TAC, TOS, OSI, TG, TC, HDL and LDL levels in all psoriasis patients. CONCLUSIONS Oxidative stress is increased in psoriasis patients regardless of their smoking status. The decreased arylesterase activity in smoker psoriasis patients suggested that smoking may be a considerable risk factor that increases the severity of psoriasis by increasing oxidative stress in these patients.
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Affiliation(s)
- S Emre
- Clinics of Dermatology Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey
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