Elucidation of Pain Mechanisms in Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful scarring abscesses, nodules, and draining tunnels in intertriginous skin. Despite being the most impactful symptom of HS and contributing to disability and chronic opioid use, HS pain remains critically understudied. Most patients with HS report pain severe enough to limit function and activities of daily living. In a global survey including more than 1900 patients, 61.4% rated their recent HS-related pain as moderate to high and 4.5% described it as the worst pain possible. Patients with HS experience dramatically reduced quality of life (QOL), utilize high-cost emergency department and inpatient care at roughly twice the rate of individuals without HS, and have reduced work ability. Acute and chronic pain contribute substantially to diminished QOL in HS. Often described as “shooting,” “hot,” or “blinding” in quality, HS pain is of equivalent severity to chronic posttraumatic headache and worse than pain experienced with blistering disorders, lichen sclerosus, and multiple sclerosis. Hidradenitis suppurativa reduces QOL to a greater extent than chronic obst ructive pulmonary disease, cardiovascular disease, and cancer across a wide range of subtypes, treatments, and tumor stages. Pain related to HS has been reported to have a greater correlation with QOL impairment than even disease severity. Patients with HS have a high risk of depression, and long-te rm opioid use is twice ...
Source: JAMA Dermatology - Category: Dermatology Source Type: research