The Impact of Surgery on Quality of Life in Hidradenitis Suppurativa: Results from a Prospective Single-Center Study

TL;DR

This study shows that major surgery significantly improves quality of life and reduces pain in patients with moderate to severe hidradenitis suppurativa.

Contribution

The study provides new evidence on the effectiveness of wide surgical excision in improving patient-reported outcomes in HS.

Findings

DLQI scores improved significantly from 11.7 pre-surgery to 4.7 at six months.

Pain and disease severity scores also showed significant decreases after surgery.

Surgery was confirmed as an essential part of a multimodal treatment approach for HS.

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that severely impairs quality of life. Treatment typically involves a patient-oriented combination of medical therapies, surgery, and lifestyle modifications. However, data on the impact of surgical treatments on quality of life remain limited. This prospective monocentric study aimed to evaluate the effect of wide surgical excision in patients with moderate to severe HS (Hurley stage II/III) who were naïve to systemic biologic treatments. Between March 2017 and November 2022, 82 patients (51% female; 80% Hurley II, 20% Hurley III) underwent major surgical excision. Assessments were performed before surgery and at three and six months postoperatively. The primary endpoint was the change in Dermatologic Life Quality Index (DLQI); secondary endpoints included changes in pain (NRS-11) and disease severity scores. DLQI improved from 11.7 at baseline to 8.3 at three months and 4.7 at six months (p < 0.001). Pain scores and the modified Hidradenitis Suppurativa Score (mHSS) also significantly decreased (p < 0.001). In conclusion, major surgery significantly improved quality of life and pain in HS patients, confirming its essential role in a multimodal treatment approach. Patient-reported outcome measures are crucial for assessing treatment efficacy in HS.

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