Hidradenitis Süpürativalı Hastaların Klinik Özellikleri ve Laboratuvar Bulgularının Değerlendirilmesi
Öz
Amaç: Hidradenitis suppurativa (HS), intertriginöz bölgelerde tekrarlayan inflame foliküler lezyonlar, nodüller, apseler ve daha sonraki evrelerde drene olan sinüs yolları ve skarlarla prezente olan kronik inflamatuar bir deri hastalığıdır. Hastalığın kronik, tekrarlayan seyri, ağrılı, kötü kokulu lezyonlar, fistül/skar oluşumu ve eşlik eden komorbiditeler nedeniyle HS, yaşam kalitesini önemli ölçüde azaltır ve psikolojik bozukluklar ile ilişkilidir. Bu çalışmada, HS'li hastaların genel özelliklerini ve hastalık şiddetini ve hastaların psikososyal durumlarını etkileyen faktörleri değerlendirmeyi amaçladık.
Gereç ve Yöntem: Bu retrospektif tanımlayıcı çalışmada HS'li 30 hastanın tıbbi kayıtları analiz edildi. Sosyodemografik veriler, hastaların genel özellikleri, HS'nin klinik özellikleri ve laboratuvar bulguları kaydedildi. Hastalardan Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ve Dermatoloji Yaşam Kalitesi İndeksini doldurmaları istendi.
Bulgular: Hidradenitis süpürativali 30 hastanın 16'sı (%53,3) kadın, 14'ü (%46,7) erkek olup yaş ortalaması 36,86 ± 12,62 yıl idi. Hurley evreleme sistemine göre hastaların %26,7'si evre I, %60'ı evre II ve %13,3'ü evre III hastalığa sahipti. Perineal/skrotal ve perianal tutulumu olan hastalarda Hurley evreleme sistemine göre hastalık şiddeti istatistiksel olarak anlamlı şekilde artmıştı. Hurley evreleme sistemine göre hastalık şiddeti ile medyan CRP düzeyleri arasında istatistiksel olarak anlamlı ilişki bulundu. Hurley evre III hastalığı olan hastalarda CRP düzeyleri Hurley evre I hastalığı olanlara göre anlamlı şekilde yüksekti. İnguinal tutulumu olan hastalarda ortalama HADS-A ve HADS-D skorları inguinal tutulumu olmayanlara göre anlamlı şekilde yüksekti. Ayrıca perianal tutulumu olan hastaların ortalama HADS-D skorları perianal tutulumu olmayanlara göre anlamlı şekilde yüksekti.
Sonuç: Bu çalışma, perineal/skrotal ve perianal tutulumu olan hastaların, hastalık şiddetinin anlamlı şekilde arttığını göstermektedir. Üstelik, inguinal ve perianal tutulumu olan hastaların anksiyete ve depresyon skorları anlamlı şekilde daha yüksekti. Klinisyenler HS'li hastalarda depresyon ve anksiyete riskinin farkında olmalıdır.
Anahtar kelimeler: anksiyete, depresyon, HADS, hidradenitis süpürativa, laboratuvar
Anahtar Kelimeler
anksiyete depresyon hads hidradenitis süpürativa laboratuvar
Etik Beyan
Etik kurul onayı mevcuttur ve yüklenmiştir.
Destekleyen Kurum
Yoktur
Kaynakça
- 1. Jalenques I, Ciortianu L, Pereira B, D'Incan M, Lauron S, Rondepierre F. The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: Systematic review and meta-analysis. J Am Acad Dermatol. 2020;83(2):542-53.
- 2. Slade DE, Powell BW, Mortimer PS. Hidradenitis suppurativa: pathogenesis and management. Br J Plast Surg. 2003;56(5):451- 61.
- 3. Calao M, Wilson JL, Spelman L, Billot L, Rubel D, Watts AD, et al. Hidradenitis Suppurativa (HS) prevalence, demographics and management pathways in Australia: A population-based cross-sectional study. PLoS One. 2018;13(7):e0200683.
- 4. Jemec GB, Heidenheim M, Nielsen NH. The prevalence of hidradenitis suppurativa and its potential precursor lesions. J Am Acad Dermatol. 1996;35(2 Pt 1):191-4.
- 5. Tzellos T, Zouboulis CC, Gulliver W, Cohen AD, Wolkenstein P, Jemec GB. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol. 2015;173(5):1142-55.
- 6. Chen WT, Chi CC. Association of Hidradenitis Suppurativa With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(9):1022-7.
- 7. Rondags A, Arends S, Wink FR, Horvath B, Spoorenberg A. High prevalence of hidradenitis suppurativa symptoms in axial spondyloarthritis patients: A possible new extra-articular manifestation. Semin Arthritis Rheum. 2019;48(4):611-7.
- 8. Hurley H, Roenigk R, Roenigk H. Dermatologic surgery, principles and practice. New York: Marcel 1989.
- 9. Schrader AM, Deckers IE, van der Zee HH, Boer J, Prens EP. Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol. 2014;71(3):460-7.
- 10. Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and benign familial pemphigus: surgical approach. Dermatologic Surgery (Roenigk RK, Roenigk HH, eds). New York: Marcel Dekker 1989.
- 11. von der Werth JM, Williams HC. The natural history of hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2000;14(5):389- 92.
- 12. Collier F, Smith RC, Morton CA. Diagnosis and management of hidradenitis suppurativa. BMJ. 2013;346:f2121.
- 13. Tzur Bitan D, Berzin D, Cohen A. Hidradenitis Suppurativa and Bipolar Disorders: A Population-Based Study. Dermatology. 2020;236(4):298-304.
- 14. Aydemir Ö, Güvenir T, Küey L, Kültür S. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry. 1997;8(4):280-7.
- 15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
- 16. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)- -a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-6.
- 17. Ozturkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of dermatology life quality index. Int J Dermatol. 2006;45(11):1300-7.
- 18. Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD. Incidence of hidradenitis suppurativa and associated factors: a population- based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133(1):97-103.
- 19. Utlu Z. Evaluation of systemic immune and inflammatory biomarkers in hidradenitis suppurativa. Eur Rev Med Pharmacol Sci. 2023;27(19):9267-72.
- 20. Andriano TM, Benesh G, Babbush KM, Hosgood HD, Lin J, Cohen SR. Serum inflammatory markers and leukocyte profiles accurately describe hidradenitis suppurativa disease severity. Int J Dermatol. 2022;61(10):1270-5.
- 21. Jimenez-Gallo D, de la Varga-Martinez R, Ossorio-Garcia L, Albarran-Planelles C, Rodriguez C, Linares-Barrios M. The Clinical Significance of Increased Serum Proinflammatory Cytokines, C-Reactive Protein, and Erythrocyte Sedimentation Rate in Patients with Hidradenitis Suppurativa. Mediators Inflamm. 2017;2017:2450401.
- 22. Riis PT, Soeby K, Saunte DM, Jemec GB. Patients with hidradenitis suppurativa carry a higher systemic inflammatory load than other dermatological patients. Arch Dermatol Res. 2015;307(10):885- 9.
- 23. Patel KR, Lee HH, Rastogi S, Vakharia PP, Hua T, Chhiba K, et al. Association between hidradenitis suppurativa, depression, anxiety, and suicidality: A systematic review and meta-analysis. J Am Acad Dermatol. 2020;83(3):737-44.
- 24. Machado MO, Stergiopoulos V, Maes M, Kurdyak PA, Lin PY, Wang LJ, et al. Depression and Anxiety in Adults With Hidradenitis Suppurativa: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(8):939-45.
- 25. Ooi XT, Choi E, Han H, Ahmad H, Patwardhan KR, Chandran NS. The psychosocial burden of hidradenitis suppurativa in Singapore. JAAD Int. 2023;10:89-94.
- 26. Kurek A, Peters EM, Chanwangpong A, Sabat R, Sterry W, Schneider-Burrus S. Profound disturbances of sexual health in patients with acne inversa. J Am Acad Dermatol. 2012;67(3):422-8, 8 e1.
Öz
Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that clinically presents with recurrent inflamed follicular lesions, nodules, abscesses, and, in later stages, draining sinus tracts and scars in intertriginous areas. Due to the chronic, recurrent course of the disease, painful, malodorous lesions, fistula/ scar formation, and accompanying comorbidities, HS significantly reduces the quality of life and is associated with psychological impairment. In this study, we aimed to evaluate the general characteristics of patients with HS and the factors influencing their disease severity and psychosocial status.
Materials & Methods: This retrospective descriptive study analyzed the medical records of 30 patients with HS. Sociodemographic data, general characteristics of the patients, clinical features of HS, and laboratory findings were noted. The patients were asked to fill out Hospital Anxiety and Depression Scales (HADS) and Dermatology Life Quality Index.
Results: Of 30 patients with HS, 16 (53.3%) were females, and 14 (46.7%) were males, with a mean age of 36.86 ± 12.62 years. According to the Hurley staging system, 26.7% of the patients had stage I, 60% had stage II, and 13.3% had stage III disease. The patients with perineal/scrotal and perianal involvement had a statistically significantly increased disease severity according to the Hurley staging system. A statistically significant relationship was found between the disease severity according to the Hurley staging system and the median CRP levels. CRP levels in the patients with Hurley stage III disease were significantly higher than those with Hurley stage I disease. The mean HADS-A and HADS-D scores in the patients with inguinal involvement were significantly higher than those without inguinal involvement. Also, the mean HADS-D scores of the patients with perianal involvement were significantly higher than those without perianal involvement.
Conclusion: This study shows that the patients with perineal/scrotal and perianal involvement had significantly increased disease severity. Moreover, the patients with inguinal and perianal involvement had significantly higher anxiety and depression scores. Clinicians should be aware of the risk of depression and anxiety in patients with HS.
Keywords: anxiety, depression, HADS, hidradenitis suppurativa, laboratory
Anahtar Kelimeler
Kaynakça
- 1. Jalenques I, Ciortianu L, Pereira B, D'Incan M, Lauron S, Rondepierre F. The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: Systematic review and meta-analysis. J Am Acad Dermatol. 2020;83(2):542-53.
- 2. Slade DE, Powell BW, Mortimer PS. Hidradenitis suppurativa: pathogenesis and management. Br J Plast Surg. 2003;56(5):451- 61.
- 3. Calao M, Wilson JL, Spelman L, Billot L, Rubel D, Watts AD, et al. Hidradenitis Suppurativa (HS) prevalence, demographics and management pathways in Australia: A population-based cross-sectional study. PLoS One. 2018;13(7):e0200683.
- 4. Jemec GB, Heidenheim M, Nielsen NH. The prevalence of hidradenitis suppurativa and its potential precursor lesions. J Am Acad Dermatol. 1996;35(2 Pt 1):191-4.
- 5. Tzellos T, Zouboulis CC, Gulliver W, Cohen AD, Wolkenstein P, Jemec GB. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol. 2015;173(5):1142-55.
- 6. Chen WT, Chi CC. Association of Hidradenitis Suppurativa With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(9):1022-7.
- 7. Rondags A, Arends S, Wink FR, Horvath B, Spoorenberg A. High prevalence of hidradenitis suppurativa symptoms in axial spondyloarthritis patients: A possible new extra-articular manifestation. Semin Arthritis Rheum. 2019;48(4):611-7.
- 8. Hurley H, Roenigk R, Roenigk H. Dermatologic surgery, principles and practice. New York: Marcel 1989.
- 9. Schrader AM, Deckers IE, van der Zee HH, Boer J, Prens EP. Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol. 2014;71(3):460-7.
- 10. Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and benign familial pemphigus: surgical approach. Dermatologic Surgery (Roenigk RK, Roenigk HH, eds). New York: Marcel Dekker 1989.
- 11. von der Werth JM, Williams HC. The natural history of hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2000;14(5):389- 92.
- 12. Collier F, Smith RC, Morton CA. Diagnosis and management of hidradenitis suppurativa. BMJ. 2013;346:f2121.
- 13. Tzur Bitan D, Berzin D, Cohen A. Hidradenitis Suppurativa and Bipolar Disorders: A Population-Based Study. Dermatology. 2020;236(4):298-304.
- 14. Aydemir Ö, Güvenir T, Küey L, Kültür S. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry. 1997;8(4):280-7.
- 15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
- 16. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)- -a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-6.
- 17. Ozturkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of dermatology life quality index. Int J Dermatol. 2006;45(11):1300-7.
- 18. Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD. Incidence of hidradenitis suppurativa and associated factors: a population- based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133(1):97-103.
- 19. Utlu Z. Evaluation of systemic immune and inflammatory biomarkers in hidradenitis suppurativa. Eur Rev Med Pharmacol Sci. 2023;27(19):9267-72.
- 20. Andriano TM, Benesh G, Babbush KM, Hosgood HD, Lin J, Cohen SR. Serum inflammatory markers and leukocyte profiles accurately describe hidradenitis suppurativa disease severity. Int J Dermatol. 2022;61(10):1270-5.
- 21. Jimenez-Gallo D, de la Varga-Martinez R, Ossorio-Garcia L, Albarran-Planelles C, Rodriguez C, Linares-Barrios M. The Clinical Significance of Increased Serum Proinflammatory Cytokines, C-Reactive Protein, and Erythrocyte Sedimentation Rate in Patients with Hidradenitis Suppurativa. Mediators Inflamm. 2017;2017:2450401.
- 22. Riis PT, Soeby K, Saunte DM, Jemec GB. Patients with hidradenitis suppurativa carry a higher systemic inflammatory load than other dermatological patients. Arch Dermatol Res. 2015;307(10):885- 9.
- 23. Patel KR, Lee HH, Rastogi S, Vakharia PP, Hua T, Chhiba K, et al. Association between hidradenitis suppurativa, depression, anxiety, and suicidality: A systematic review and meta-analysis. J Am Acad Dermatol. 2020;83(3):737-44.
- 24. Machado MO, Stergiopoulos V, Maes M, Kurdyak PA, Lin PY, Wang LJ, et al. Depression and Anxiety in Adults With Hidradenitis Suppurativa: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(8):939-45.
- 25. Ooi XT, Choi E, Han H, Ahmad H, Patwardhan KR, Chandran NS. The psychosocial burden of hidradenitis suppurativa in Singapore. JAAD Int. 2023;10:89-94.
- 26. Kurek A, Peters EM, Chanwangpong A, Sabat R, Sterry W, Schneider-Burrus S. Profound disturbances of sexual health in patients with acne inversa. J Am Acad Dermatol. 2012;67(3):422-8, 8 e1.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Dermatoloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Mayıs 2025 |
| Gönderilme Tarihi | 9 Ekim 2024 |
| Kabul Tarihi | 23 Şubat 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 58 Sayı: 1 |
