Supplementary Material for: Factors associated with severe hidradenitis suppurativa, using Hurley staging and Metascore

Introduction. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease for which certain risk factors are well known: obesity and smoking (in particular). However, the factors associated with more severe conditions, and therefore potential aggravators of the disease, remain a matter of debate.
Our study aims to determine the clinical factors associated with severe HS using several severity scores.
Methods. The data were obtained via the ERHS questionnaire from patients exclusively recruited at Erasme Hospital in Brussels. The severity of HS was firstly estimated by the Hurley score, and secondly by a metascore, a system combining the iHS4, HS-PGA, SAHS and DLQI. Univariable and multivariable analyses were performed.
Results. Six hundred and forty-seven patients were included in the Hurley analysis, and 456 patients in the metascore analysis. In multivariable analysis, men have a more severe metascore than women (OR = 1.89, p = 0.022), smoking was associated with a more severe disease according to metascore, especially in mild cases (OR = 0.76, p = 0.043), and an elevated BMI was associated with having Hurley stage III disease compared to Hurley I or II disease (OR = 1.09, p = 0.001). A significant association is also shown between blood pressure and Hurley stage (OR = 0.97, p = 0.025). Self-reports of NSAIDs aggravating the disease is also a factor associated with greater severity according to the metascore (OR = 0.12, p = 0.008). Finally, several locations of HS lesions were associated with greater severity, in particular the armpits according to the metascore (OR = 0.29, p < 0.001), and the perianal area according to the Hurley score (OR = 0.15, p < 0.001).
Conclusion. HS seems to be more severe in men, smoking seems to aggravate mild cases of HS, while increased body mass index plays a major role in the transition from Hurley II to Hurley III.

引言。化脓性汗腺炎（Hidradenitis suppurativa, HS）是一种慢性炎症性皮肤病，已知的危险因素包括肥胖与吸烟（尤以吸烟为重）。然而，与疾病严重程度升高相关、即潜在加重病情的危险因素仍存在争议。
本研究旨在通过多种病情严重程度评分体系，明确与重症化脓性汗腺炎相关的临床危险因素。
方法。本研究的数据来源于布鲁塞尔艾尔梅斯医院（Erasme Hospital）招募的全部受试者，通过ERHS问卷收集。化脓性汗腺炎的病情严重程度首先通过赫利评分（Hurley score）进行评估，其次采用复合评分系统（metascore）进行评估，该系统整合了iHS4、HS-PGA、SAHS及DLQI四项评分指标。本研究采用单变量及多变量分析方法开展统计分析。
结果。本研究的赫利评分分析共纳入647例受试者，复合评分分析共纳入456例受试者。多变量分析结果显示：男性的复合评分严重程度显著高于女性（优势比[OR]=1.89，P=0.022）；根据复合评分结果，吸烟与病情严重程度升高相关，尤其在轻症患者中更为显著（OR=0.76，P=0.043）；与赫利I期或II期患者相比，体重指数（BMI）升高与赫利III期疾病显著相关（OR=1.09，P=0.001）。血压水平与赫利分期亦存在显著关联（OR=0.97，P=0.025）。受试者自述非甾体抗炎药（NSAIDs）可加重病情，该因素同样与复合评分提示的病情严重程度升高相关（OR=0.12，P=0.008）。最后，化脓性汗腺炎皮损的多个发病部位与病情严重程度升高显著相关：其中复合评分提示腋窝部位皮损与病情加重密切相关（OR=0.29，P<0.001），赫利评分则提示肛周部位皮损与病情加重显著相关（OR=0.15，P<0.001）。
结论。男性化脓性汗腺炎患者病情往往更为严重；吸烟可加重轻症化脓性汗腺炎患者的病情；而体重指数升高则在赫利II期向赫利III期病情进展的过程中发挥关键作用。