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TOPLINE
Hidradenitis suppurativa (HS) severely impaired quality of life (QOL) across all disease stages, with more than one third of patients classified as having clinically mild disease reporting a very severe impact on QOL, a new study found. Female sex, smoking, anxiety, depression, pain intensity, and the presence of draining tunnels were associated with worse QOL outcomes.
METHODOLOGY
- Researchers analysed baseline data from 1188 participants (mean age, 37.7 years; 53.4% women) with HS enrolled in the Spanish Hidradenitis Suppurativa Registry between June 2023 and September 2025.
- Data collection included demographics, clinical characteristics (Hurley stage, International Hidradenitis Suppurativa Severity Score [IHS4], lesion counts, and pain scores), and QOL measured using the Hidradenitis Suppurativa Quality of Life (HiSQOL) instrument.
- The researchers evaluated associations between severe/very severe QOL impairment (HiSQOL total score, 22-68) and various clinical and demographic factors.
- Participants were classified by Hurley stage: 27.4% in stage 1, 50.9% in stage 2, and 21.7% in stage 3; they were also classified by IHS4: 36.3% with mild disease, 38.9% with moderate disease, and 24.8% with severe disease.
TAKEAWAY
- The mean total HiSQOL score was 24.4, indicating very severe QOL impairment; 39.1% of participants with Hurley stage 1 and 33.8% of those with mild IHS4 reported very severe QOL impairment.
- Female sex was associated with worse QOL (odds ratio [OR], 1.5; P = .002), as were current smoking (OR, 1.8; P < .001), anxiety (OR, 1.5; P = .007), and depression (OR, 1.8; P < .001).
- The presence of at least one draining tunnel (OR, 2.1 for one to two tunnels; P < .001; OR, 3.2 for three to six tunnels; P < .001) and lesion localisation in specific areas such as the armpits (OR, 1.5; P < .001), groin (OR, 2.0; P < .001), genitals (OR, 1.4; P = .019), or trunk (OR, 1.6; P = .028) were associated with severe QOL impairment.
- The HiSQOL total score showed a weak correlation with Hurley stage (Pearson's correlation coefficient [r], 0.2) and IHS4 (r, 0.3) but showed a moderate correlation with pain intensity (r, 0.6), demonstrating a disconnect between clinical severity and patient-reported burden.
IN PRACTICE
"[The] results establish HiSQOL as a sensitive and essential tool for identifying high-impact patients in daily practice, supporting a more comprehensive, biopsychosocial approach to HS management," the authors of the study concluded.
SOURCE
The study was led by José C. Pascual, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain. It was published online on August 21, 2026, in the Journal of the European Academy of Dermatology & Venereology.
LIMITATIONS
All participating sites were located within Spain, which may have limited the generalisability of the findings. The lack of concurrent Dermatology Life Quality Index data limited direct comparison with historical datasets.
DISCLOSURES
This study did not receive any specific funding. Pascual disclosed receiving honoraria for consulting, lectures, and educational events from AbbVie, UCB, and Novartis. Full disclosures are noted in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
