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Hidradenitis suppurativa is an inflammatory skin disease for which adalimumab is an effective treatment in just over half of cases. Few factors associated with therapeutic response, and therefore potentially predictive of response, are known to date. This real-life study retrospectively explores the existence of such factors in a Belgian cohort of 82 patients, using several response scores: the Hidradenitis Suppurativa Clinical Response (HiSCR), the International Hidradenitis Suppurativa Severity Scoring System-55 (iHS4-55), and the dynamic metascore (a combination of the Hurley score, the 2007 version of the Sartorius score, the iHS4 and the HiSCR). Among the factors associated with a good therapeutic response, we find, for example, the "Frictional furunculoid" and "Conglobata" phenotypes, in contrast to the "Scarring folliculitis" phenotype, which is associated with a poorer response to treatment. Other factors associated with a good response to treatment were observed, such as the patient's description of longer flares, or, among others, the presence of inflammatory bowel disease. Subject to our sample size, the window of opportunity for adalimumab, whereby the treatment would be more effective if administered earlier, was not found in this study. [ABSTRACT FROM AUTHOR]

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 (odds ratio [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 body mass index 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 nonsteroidal anti-inflammatory drugs 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. [ABSTRACT FROM AUTHOR]