Delays in the diagnosis of hidradenitis suppurativa (HS) are associated with more severe disease and the development of concomitant disorders, according to the findings of a recent study. The study, published in Dermatology, showed that it can take up to 10 years for patients to receive a diagnosis of HS.
“HS is a neglected chronic inflammatory disease with long delay in diagnosis,” the researchers said. “Besides pain, purulent discharge, and destruction of skin architecture, patients with HS experience metabolic, musculoskeletal, and psychological disorders.”
In the prospective, multicenter, epidemiologic, cross-sectional study, the researchers evaluated data of 394 adult patients in Germany. Patients completed questionnaires and underwent a medical examination performed by dermatologists.
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The researchers found that the average duration from the manifestation of the first symptoms until HS diagnosis was 10.0 ± 9.6 (mean ± SD) years. During this time, patients with HS visited more than three different physicians on average and had more than three misdiagnoses, the researchers said. Furthermore, patients who were younger and did not smoke experienced longer delays in receiving an HS diagnosis.
Patients most frequently sought care from general practitioners, dermatologists, surgeons, and gynecologists. Dermatologists correctly diagnosed HS in most cases, the researchers noted.
“The longer the delay of diagnosis, the greater the disease severity at diagnosis,” they said. In addition, delayed HS diagnosis was associated with an increased number of surgically treated sites, concomitant diseases, and missed days of work.
“This study demonstrates an enormous delay in the diagnosis of HS, which results in more severe disease,” the researchers concluded. “It also shows for the first time that a delay in diagnosis of a chronic inflammatory disease leads to a higher number of concomitant systemic disorders.”
Kokolakis G, Wolk K, Schneider-Burrus S, et al. Delayed diagnosis of hidradenitis suppurativa and its effect on patients and healthcare system. Dermatology. Published online July 1, 2020. doi:10.1159/000508787