Surgery Associated with Worse Mental Health Outcomes for Hidradenitis Suppurativa Patients

Article

Mental health outcomes for those with hidradenitis suppurativa who have had a previous surgery were explored in recent research.

Falk G. Bechara, MD

Falk G. Bechara, MD

Patients with hidradenitis suppurativa (HS) were found to have worse mental health and quality of life outcomes if previous surgical interventions had occurred, according to new findings.1

This chronic, inflammatory skin disorder frequently requires some kind of surgical intervention depending on the disease’s level of severity. Consequently, the study was viewed to be important for a greater assessment of HS patient needs.

This research was authored by Falk G. Bechara, MD, from the Department of Dermatology, Venereology, and Allergology at St. Josef-Hospital, Ruhr-University Bochum in Germany.

“The purpose of this study was to investigate predictive factors for progression of HS, to explore the burden of the disease on patients and society, and to collect data regarding the medical history of patients with HS in Germany, including prior interventions,” Bechara and colleagues wrote.

Background and Findings

The investigators conducted a non-interventional, prospective, multicenter study at 64 sites in Germany for their research, titled the “Predictive markers for progressive disease progression in Acne Inversa (AI)/ HS patients” (PIRANHA) study.

The primary goal of the investigators was to determine the predictive markers for HS progression and to collect information on management of those with the inflammatory skin disease living in Germany.

The team collected data on HS’s course, patients’ medical histories, medical examinations, and patient-reported outcomes.

Some of these outcomes were the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale, and the Short Form-12 Health Survey.

The investigators ended up with 481 HS patients recruited for their study, and concluded that 74.2% had reported a surgery prior to inclusion in the study.

Of those who reported a surgery, 92.4% were able to identify their surgery type and location. The research team noted that study participants without any previous surgical interventions achieved substantially better scores than those who did get surgeries.

They also added that after adjusting for confounding variables including HS severity and activity, the outcomes of those who had received surgery did not tend to vary much between recipients of different techniques and between those with different numbers of prior surgeries.

Overall, outcomes for those with prior surgical interventions were worse on average than those without any surgeries.

“Regardless of the causative role of surgery on the patient's psychosocial well-being, the implementation of measures for an improved surgical management of patients with HS is warranted,” they wrote. “Regarding the invasiveness of certain surgical techniques and the concomitant pain and temporary disablement of the patient, a careful risk-benefit assessment is required in this particularly vulnerable patient group.”

References:

  1. Scholl, L, Schneider-Burrus, S, Fritz, B, Sabat, R, Bechara, FG. The impact of surgical interventions on the psychosocial well-being of patients with hidradenitis suppurativa. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2023; 1- 9. https://doi.org/10.1111/ddg.14934.
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