Supplementary Material for: Proposed Definitions of Typical Lesions in Hidradenitis Suppurativa

<b><i>Background:</i></b> Although not rare, hidradenitis suppurativa (HS) is often under-recognized by physicians. The diagnosis of HS is clinical via the recognition of lesions typical of the disease, but universally accepted definitions of these latter are currently lacking, which means that certain severity scores employed for HS classification/management are used differently by different physicians. Our aim was to develop a set of descriptive definitions and associated images of HS lesions, in order to enable doctors to better recognize and evaluate the disease. <b><i>Methods:</i></b> MEDLINE-available literature and dermatological textbooks on HS morphology were retrieved (January 1996 to February 2016). A preliminary set of definitions of HS typical lesions was created, including 10 terms. Each term was associated with a pathophysiological classification and an image. This preliminary set was shown during the 5th Conference of the European HS Foundation (EHSF). The physicians attending the event were invited to vote on each term and make comments via a voting sheet. <b><i>Results:</i></b> A total of 81 physicians answered the questionnaire. Their agreement/disagreement rates and comments were used to obtain a revised set of definitions and images. Pathophysiological classifications were dropped. <b><i>Conclusion:</i></b> A user-friendly set of definitions/images of HS typical lesions was proposed and will need to be validated by further studies. This set could ultimately serve as a tool to better recognize, score, and assess treatment efficacy.

<b><i>研究背景：</i></b> 化脓性汗腺炎（hidradenitis suppurativa, HS）虽并非罕见疾病，但常被临床医师忽视。HS的诊断需通过识别疾病典型皮损完成，但目前尚无针对此类皮损的通用公认定义，这导致不同医师对HS分类与管理中使用的多种严重程度评分的应用方式存在差异。本研究旨在建立一套HS皮损的描述性定义及配套图像，以帮助临床医师更好地识别与评估该疾病。
<b><i>研究方法：</i></b> 检索1996年1月至2016年2月期间可在MEDLINE数据库获取的相关文献及皮肤病学教科书中关于HS皮损形态学的内容。初步建立了包含10个术语的HS典型皮损定义集，每个术语均关联病理生理学分类与一幅图像。该初步定义集在欧洲HS基金会（European HS Foundation, EHSF）第五届大会上进行展示，并邀请参会医师通过投票表对每个术语进行投票并提出意见。
<b><i>研究结果：</i></b> 共有81名医师参与了问卷调研。研究团队结合医师的同意/反对率及意见，对定义集与图像进行了修订，并移除了原有的病理生理学分类部分。
<b><i>研究结论：</i></b> 本研究提出了一套便于临床使用的HS典型皮损定义与图像集，后续仍需更多研究对其进行验证。该数据集有望成为更好地识别HS、进行病情评分及评估治疗效果的工具。