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    Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study
    (Karger, 2024) Alpsoy, Erkan; Karaman, Bilge Fettahlioglu; Demirseren, Duriye Deniz; Cinar, S. Levent; Kacar, Nida; Ermertcan, Aylin Turel; Baskan, Emel Bulbul
    Introduction:The natural history, the progression of a diseaseprocess in an individual over time, has not yet been fully elu-cidated in hidradenitis suppurativa (HS). In this large multicenterstudy, we aimed to investigate the natural history of HS and itsgender differences.Methods:This cross-sectional study in-cluded 827 patients. The chronological order of the clinicalmanifestations for each patientwas recorded retrospectively.Sociodemographic characteristics, triggering factors, clinical,treatment, and prognostic features were also evaluated.Results:The mean age of disease onset was significantly younger inwomen than in men (22.42 +/- 9.28 vs. 27.06 +/- 20.56,p<0.001)and those with a family history (p<0.0001). The mean diseaseduration was 91.17 +/- 83.64 months. The most commonsymptom was purulent discharge (81%). The mean duration ofabscess was shorter in women than in men (3.11 +/- 2.65 vs.3.75 +/- 3.75,p= 0.01). The axilla was the most common onsetarea followed by the inguinal and gluteal regions. The diseaseran a more severe course in men. Abscess/inflammatory nodulewas defined in the last 6 months in 88.6% of the patients;however, thefirst 5 years of the disease were the most activedisease period in 67.5% of the patients. Multivariate analysisrevealed being male, older age, family history, involvement ofthe axillary, inguinal, and perianal regions independently as-sociated with HS severity. While antibiotic use was the mostimportant factor in improving thedisease symptoms, stress wasthe most common aggravating factor. Biological therapy in men,laser epilation and pregnancy in women were significant alle-viating factors, whereas weight gain was a more commonaggravating factor for women.Conclusion:HS shows a re-lentlessly progressive course with inflammatory attacks, but thefirst years of the disease are the most active period. This studyconfirms that environmental and hormonal factors may play animportant role in the disease course, probably with other en-dogenous or exogenous factors.(c) 2024 S. Karger AG, Basel