Hidradenitis suppurativa with and without draining tunnels: A real-world study characterizing differences in treatment and disease burden

Ingram, J. R. ORCID: https://orcid.org/0000-0002-5257-1142, Marzano, A. V., Prens, E., Schneider-Burrus, S., Warren, R. B., Keal, A., Jha, R., Hernandez Daly, A. C. and Kimball, A. B. 2025. Hidradenitis suppurativa with and without draining tunnels: A real-world study characterizing differences in treatment and disease burden. Journal of the European Academy of Dermatology and Venereology 10.1111/jdv.20550

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Abstract

Background Hidradenitis suppurativa (HS) is a chronic, inflammatory, neutrophilic skin disease associated with a considerable clinical burden. In more severe disease, subepidermal draining tunnels may form. Objectives To characterize the clinical profile of patients with moderate–severe HS with and without draining tunnels, and the clinical and health-related quality of life (HR-QoL) burden of draining tunnels. Methods Data were drawn from the Adelphi HS Disease Specific Programme™, a cross-sectional survey with retrospective data collection, across the United States, France, Germany, Italy, Spain and the United Kingdom between November 2020 and April 2021. Patients were aged ≥10 years and had HS. Clinical outcomes, recorded by physicians, comprised patient demographics and HS characteristics, symptoms and treatment. HR-QoL measures included patient and physician survey questions, and validated HR-QoL instruments. Results Of the 580 patients with moderate–severe HS, 46% had draining tunnels. Patients with draining tunnels had more abscesses, inflammatory nodules and scarring than those without. Patients with draining tunnels were significantly (p < 0.05) more likely to be treated with biologics (41% vs. 27%), but often patients with tunnels who were eligible for biologics had not received them. Patients with draining tunnels experienced significantly more inflammation/redness (73% vs. 63%), drainage from lesions (62% vs. 40%) and pain on sitting (48% vs. 37%) than those without (p < 0.05). Draining tunnels were also significantly associated with low mood/depression (30% vs. 18%), sleep disturbance (28% vs. 19%) and fatigue (28% vs. 18%) versus no tunnels (p < 0.05). Physicians agreed that patients with draining tunnels experienced a negative impact of disease compared to those without. This was reflected in patient-reported surveys and HR-QoL instruments. Conclusions Patients with moderate–severe HS and draining tunnels experience greater clinical and HR-QoL burden than those without, emphasizing the importance of tunnels in disease impact.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Publisher:	Wiley
ISSN:	0926-9959
Date of First Compliant Deposit:	5 February 2025
Date of Acceptance:	3 January 2025
Last Modified:	03 Mar 2025 10:29
URI:	https://orca.cardiff.ac.uk/id/eprint/175947

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