HİDRADENİTİS SÜPÜRATİVA HASTALARININ EPİDEMİYOLOJİK VE KLİNİK ÖZELLİKLERİ: ÜÇÜNCÜ BASAMAK BİR MERKEZİN 10 YILLIK DENEYİMİ

Amaç: Bu çalışmada hidradenitis süpürativa (HS) hastalarının epidemiyolojik ve klinik özelliklerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Üçüncü basamak bir merkezde yürütülen bu retrospektif kesitsel çalışmada, 2012-2022 tarihlerinde tanı alan ve/veya takip edilen HS hastaları demografik özellikler, klinik bulgular, eşlik eden komorbiditeler, HS için verilen tedaviler ve tedavi yanıtları açısından değerlendirilmiştir. Bulgular: 101 HS hastasının (erkek:kadın oranı=1,7:1) %23,3’ünde (n=20) erken başlangıç (<18 yaş) öyküsü mevcuttu. Hastaların büyük çoğunluğunda (%82,7; n=62) ailede HS öyküsü yoktu. Hastaların hastalık şiddetine göre dağılımları Hurley I (%33,7; n=34), Hurley II (%46,5; n=47), Hurley III (%19,8; n=20) şeklindeydi. Erken başlangıçlı ve Hurley III HS hastalarında anlamlı ölçüde daha fazla anatomik bölge tutulumu saptandı (p<0,05). En sık tutulum görülen anatomik yerleşim aksiller bölge (n=78) olup, bunu inguinal (n=57) ve gluteal bölge (n=23) takip etmekteydi. Altmışdört hasta (%74,4) kilolu/obez olup hastaların %84,5’inde (n=71) güncel/geçmiş sigara kullanım öyküsü mevcuttu. HS’e en sık eşlik eden dermatolojik hastalık akne vulgaristi (n=23). Olguların %25,5’inde (n=25) pilonidal sinüs hastalığı mevcuttu. Hurley III HS hastaları önemli ölçüde daha yüksek oranda pilonidal sinüs hastalığı, gluteal ve perianal bölge tutulumu ile başvurdu (p<0,05). Ondokuz hasta metabolik sendrom tanısı almıştı. Sistemik antibiyotikler en sık reçete edilen birinci basamak ajanlardı. Hidradenitis Süpürativa Klinik Yanıtı (HiSCR) en yüksek oranda biyolojik ajanlarla (özellikle adalimumab) gözlendi Sonuç: Mevcut literatür ile uyumlu olarak, HS ilişkili olduğu komorbiditeler ile birlikte hastalık yükünü arttırmaktadır. HS hastalarımızda erkek cinsiyet baskınlığı ve anatomik tutulum paternleri daha önce bildirilen Türk serileri ile uyumludur. Pilonidal sinüs hastalığı, gluteal ve perianal bölge tutulumu HS hastalarında şiddetli hastalık açısından yakın zamanlı çalışmalarda da vurgulanan önemli belirtilerdir. Biyolojik ajanlar, özellikle şiddetli HS formlarında, HiSCR sağlamak için en iyi tedavi seçeneği olarak görünmektedir.

Anahtar Kelimeler:

Hidradenitis süpürativa, Hurley, kronik inflamasyon, metabolik sendrom, pilonidal sinüs

EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HIDRADENITIS SUPPURATIVA PATIENTS: 10-YEAR EXPERIENCE FROM A SINGLE TERTIARY CENTER

Objective: To investigate the clinico-epidemiological profile of hidradenitis suppurativa (HS) patients. Material and Method: In this retrospective cross-sectional single tertiary center study, the HS patients diagnosed and/or followed up between 2012-2022 were evaluated regarding demographic features, clinical findings, associated comorbidities, therapies initiated for HS and their outcomes. Results: Of 101 HS patients (male:female ratio=1.7:1), 23.3% (n=20) had a history of early-onset disease (<18 years). The majority had no family history of HS (82.7%, n=62). The patients were classified according to disease severity as Hurley I (33.7%, n=34), Hurley II (46.5%, n=47) and Hurley III (19.8%, n=20). Patients with early-onset disease and Hurley III HS had a significantly higher number of affected anatomical sites (p<0.05). The axillary region was the most commonly involved anatomical site (n=78), followed by the inguinal (n=57) and gluteal regions (n=23). Sixty-four patients (74.4%) were overweight/obese, and 84.5% (n=71) were current or ex-smokers. Acne vulgaris was the main dermatological comorbidity associated with HS (n=23). Pilonidal sinus disease was present in 25.5% (n=25). Patients with Hurley III HS presented with significantly higher rates of pilonidal sinus disease and involvement of the gluteal and perianal regions (p<0.05). Nineteen patients were diagnosed with metabolic syndrome. Systemic antibiotics were the most frequently prescribed first-line agents. Hidradenitis Suppurativa Clinical Response (HiSCR) achievement was observed most frequently with biologics, particularly adalimumab. Conclusion: In line with the current literature, HS poses an increased disease burden with its associated comorbidities. The predominance of the male sex and the anatomical involvement patterns seen in our HS patients are compatible with previously reported Turkish series. Pilonidal sinus disease and involvement of the gluteal and perianal regions in HS patients are important signs of severe disease, also highlighted in recent studies. The biologic agents seem to be the best therapeutic option for achieving HiSCR, especially in severe HS forms.

Keywords:

Hidradenitis suppurativa, Hurley, chronic inflammation, metabolic syndrome, pilonidal sinus,

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