Hidradenitis suppurativa and electrocardiographic changes: a cross‐sectional population study

Hidradenitis Suppurativa (HS) is a chronic skin condition that usually develops after puberty. It causes recurrent painful boils in the armpits, groins, genital region and other areas with skin folds. Beyond the debilitating skin problems, the disease is associated with several factors that increase risk of cardiovascular disease (smoking, obesity, metabolic syndrome and systemic inflammation) and recently, higher risk of developing cardiovascular disease. The aim of this study from Denmark was to investigate this possible cardiovascular burden associated with HS influence on the heart's electrical activity. To fulfil this aim, several electrocardiographic parameters were compared between HS patients and a control group. The HS patients were identified using a questionnaire which also was used to divide the HS patients into severity groups (mild, moderate and severe). Overall 404 HS patients and 19,001 controls were identified in the population. The heart's electrical activity parameters investigated were heart rate, and measurements called PR‐interval, QRS‐duration, JTcF‐ and QTcF‐interval. The analyses performed in this study took into account age, sex, smoking and body mass index. The main finding of this study was a higher heart rate for the patients with severe HS compared to the control group. Other findings were a shorter QRS‐duration (the depolarization of the ventricles of the heart) for the patients with mild HS, a result which needs further investigation, and no difference for the parameters PR‐interval, JTcF‐interval and QTcF‐interval. The conclusion of this study is that severe HS is associated with a higher resting heart rate. Given that resting heart rate is associated with increased mortality, and that HS patients have increased risk of cardiovascular issues, this finding is potentially important, easily testable and allows for treatment.     

Prevalence of hidradenitis suppurativa among patients with Down syndrome: a population‐based cross‐sectional analysis

Hidradenitis suppurativa (HS) is a debilitating, chronic, painful inflammatory disease. Scientists have previously suggested that there is a potential genetic link predisposing Down syndrome patients to the development of HS through the increased formation of the amyloid precursor protein. However, this laboratory based finding had not previously been verified in the population. In this study, we evaluated the commonness of hidradenitis suppurativa within a large group of patients who had Down syndrome, and we used another groups of patients that did not have Down syndrome to compare findings. We observed that the diagnosis of hidradenitis suppurativa was present among 2.1% of patients with Down syndrome over the past five years. Compared to those without Down syndrome, patients with the condition had five times the likelihood of having hidradenitis suppurativa during the period of the study. Hidradenitis suppurativa was most common among Down syndrome patients who were aged 18–29 years. Hidradenitis suppurativa affected males and females, and whites and non‐whites, with Down syndrome equally. The diagnosis of hidradenitis suppurativa is made at a younger age among patients with Down syndrome, compared to patients without the condition. This suggests that hidradenitis may occur earlier in life among patients with Down syndrome, or it may occur more severely and thereby prompt earlier visits to the doctor for this condition. It is also possible that hidradenitis suppurativa is diagnosed earlier among patients with Down syndrome because doctors may be examining patients with Down syndrome more frequently in general.     

A multicentre,cross‐sectional study on quality of life in patients with cutaneous lupus erythematosus

Background A study at the University of Pennsylvania (UPenn) Medical Center demonstrated that quality of life in patients with cutaneous lupus erythematosus (CLE) is negatively impacted. Whether patients with CLE in other geographic locations have similar quality of life is unknown. Objectives We sought to compare quality of life indicators between patients with CLE at the University of Texas Southwestern (UTSW) Medical Center at Dallas and those at UPenn. Methods Patients with CLE (total n = 248) at UTSW (n = 91) and UPenn (n = 157) completed the Skindex‐29 + 3 and Short Form‐36 (SF‐36) surveys related to quality of life. Additional information, including demographics, presence of systemic lupus erythematosus (SLE) and disease severity, was collected from UTSW patients with CLE. Results Most Skindex‐29 + 3 and SF‐36 subdomain scores between UTSW and UPenn patients with CLE were similar. However, UTSW patients with CLE were significantly more affected in the functioning and lupus‐specific Skindex‐29 + 3 domains, and physical functioning, role‐physical and general health SF‐36 subscales than UPenn patients with CLE (P < 0·05). Factors related to poor quality of life in UTSW patients with CLE include sex, income, education, presence of SLE, and skin disease activity. Conclusions Most quality of life indicators were similar between the two CLE populations. Differences in psychosocial behaviour, and a larger proportion of patients with SLE and females in the UTSW group likely attributed to differences in a minority of Skindex‐29 + 3 and SF‐36 subdomains. Capturing data from CLE populations in different locations provides a more thorough picture of the quality of life that patients with CLE experience on a daily basis with special attention to quality of life issues in select patients with CLE.     

Comorbidities,metabolic risk profile and health‐related quality of life in German patients with plaque‐type psoriasis: a cross‐sectional prospective study

Background Patients with psoriasis experience a higher risk of cardiovascular and metabolic comorbidities and have a high burden of treatment. There is still a gap between treatment options and quality of care. The purpose of this study was to determine the demographic data, comorbidities, and the limitations of quality of life in patients with plaque‐type psoriasis. Materials and methods This epidemiological evaluation was designed as a single‐center, cross‐sectional, prospective study in Marburg, Germany. To investigate the association between mild to severe psoriasis and comorbidities, data were obtained from 133 patients. Results The average Psoriasis Area and Severity Index was 13.4, and the average Dermatology Life Quality Index was 6.3. Among the patients with severe psoriasis, 95% had been prescribed systemic treatments. Comorbidities were evaluated, with depression 30.8%, arterial hypertension 39.1%, and hypercholesterolemia 20.3% in all patients. Conclusions Our findings underscore the importance of cardiovascular and metabolic risk screening for all patients with psoriasis. There is still a need for systemic treatments and the definition of treatment goals for psoriasis as a systemic inflammatory disease. Such goals should integrate parameters that include comorbidities and an improvement in health‐related quality of life.     

Psychosocial impact of hidradenitis suppurativa: a qualitative study

Hidradenitis suppurativa influences patients' lives in many ways. It is therefore necessary to focus on the effects of the disease on daily life in order better to define patient-related outcomes in hidradenitis suppurativa studies. Interviews were conducted with 12 patients with hidradenitis suppurativa. Initial single interviews were followed by semi-structured and structured qualitative focus group interviews in order to improve the richness of the data and obtain in-depth understanding of the impact of the topics. Important topics were found to relate to aspects of interpersonal contact, especially in relation to smell and appearance, various emotional reactions, and feelings of lack of control. It was found that hidradenitis suppurativa has a great emotional impact on patients and promotes isolation due to fear of stigmatization. Shame and irritation are frequent and relate to smell, scars, itching and pain. Quality of life is adversely affected and professional support is needed.