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Association of Hidradenitis Suppurativa With Body Image.

Abstract

Importance

Hidradenitis suppurativa (HS) leads to disfigurement and painful eruptions in terminal hair follicles of the intertriginous skin, mainly of axillary, genitofemoral, and perianal sites. It is associated with an excessive impairment of quality of life, psychiatric disorders, and sexual distress. Body image impairment has been linked to depression and anxiety and has been described for some dermatologic disorders but has not yet been investigated in patients with HS.

Objectives

To investigate whether body image is diminished in patients with HS and whether disease severity, age at onset, disease duration, obesity, depression, and anxiety are linked to body image impairment.

Design, Setting, and Participants

This 12-month (August 1, 2009, to August 31, 2010) case-control study with a prospective, observational, cross-sectional design recruited 47 consecutive patients with HS entering a tertiary care center and 45 healthy control individuals matched for age, sex, and body mass index (BMI). One patient and 4 controls failed to complete the questionnaire and were excluded from the evaluation. Data analysis was performed from December 1, 2013, to February 15, 2014.

Main Outcomes and Measures

The Frankfurt Body Concept Scale (FKKS) and the Hospital Anxiety and Depression Scale (HADS) were given to patients and controls. Correlations among FKKS, HADS, and disease features were calculated.

Results

Of the 46 patients and 41 controls included in the evaluation (mean [SD] age, 35.6 [1.6] years; 40 [46%] male and 47 [54%] female), HS significantly reduced body image (mean FKKS score, 234.2 [5.4] in patients and 276.9 [5.7] in controls; P < .001), even when controlled for BMI. A correlation was found for the extent of body image disruption and BMI (r = -0.589; P < .001), HADS-depression score (r = -0.619; P < .001), and HADS-anxiety score (r = -0.340; P = .03). No association was found for the body image score and the severity of HS, age at onset of disease, and duration of disease. The body contact subscale score was the only subscale score that was not different between patients with HS and controls.

Conclusions and Relevance

Patients with HS have major body image impairment, which might lead to depression and anxiety, disorders that have been largely acknowledged in HS. This study identified another element of the psychosocial burden of patients with HS and reveals that body image could potentially be used as an outcome measure in future studies of HS.

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  • Authors+Show Affiliations

    ,

    Department of Dermatology and Allergy, University Hospital Charité, Berlin, Germany. Center for Dermatosurgery, Havelklinik, Berlin, Germany.

    ,

    Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, University Hospital Charité, Berlin, Germany.

    ,

    Department of Dermatology and Allergy, University Hospital Charité, Berlin, Germany. Division for General Internal Medicine, Psychosomatics and Psychotherapy, University Hospital Charité, Berlin, Germany. Department of Psychosomatics and Psychotherapy, Justus-Liebig-University, Gieβen, Germany.

    ,

    Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, University Hospital Charité, Berlin, Germany. Psoriasis Research and Treatment Center, University Hospital Charité, Berlin, Germany.

    ,

    Department of Dermatology and Allergy, University Hospital Charité, Berlin, Germany.

    Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, University Hospital Charité, Berlin, Germany. Psoriasis Research and Treatment Center, University Hospital Charité, Berlin, Germany.

    Source

    JAMA dermatology 154:4 2018 04 01 pg 447-451

    MeSH

    Adult
    Anxiety
    Body Image
    Body Mass Index
    Case-Control Studies
    Cross-Sectional Studies
    Depression
    Female
    Hidradenitis Suppurativa
    Humans
    Male
    Prospective Studies
    Psychiatric Status Rating Scales
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Observational Study

    Language

    eng

    PubMed ID

    29466546

    Citation

    Schneider-Burrus, Sylke, et al. "Association of Hidradenitis Suppurativa With Body Image." JAMA Dermatology, vol. 154, no. 4, 2018, pp. 447-451.
    Schneider-Burrus S, Jost A, Peters EMJ, et al. Association of Hidradenitis Suppurativa With Body Image. JAMA Dermatol. 2018;154(4):447-451.
    Schneider-Burrus, S., Jost, A., Peters, E. M. J., Witte-Haendel, E., Sterry, W., & Sabat, R. (2018). Association of Hidradenitis Suppurativa With Body Image. JAMA Dermatology, 154(4), pp. 447-451. doi:10.1001/jamadermatol.2017.6058.
    Schneider-Burrus S, et al. Association of Hidradenitis Suppurativa With Body Image. JAMA Dermatol. 2018 04 1;154(4):447-451. PubMed PMID: 29466546.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association of Hidradenitis Suppurativa With Body Image. AU - Schneider-Burrus,Sylke, AU - Jost,Agata, AU - Peters,Eva Milena Johanna, AU - Witte-Haendel,Ellen, AU - Sterry,Wolfram, AU - Sabat,Robert, PY - 2018/2/22/pubmed PY - 2019/5/22/medline PY - 2018/2/22/entrez SP - 447 EP - 451 JF - JAMA dermatology JO - JAMA Dermatol VL - 154 IS - 4 N2 - Importance: Hidradenitis suppurativa (HS) leads to disfigurement and painful eruptions in terminal hair follicles of the intertriginous skin, mainly of axillary, genitofemoral, and perianal sites. It is associated with an excessive impairment of quality of life, psychiatric disorders, and sexual distress. Body image impairment has been linked to depression and anxiety and has been described for some dermatologic disorders but has not yet been investigated in patients with HS. Objectives: To investigate whether body image is diminished in patients with HS and whether disease severity, age at onset, disease duration, obesity, depression, and anxiety are linked to body image impairment. Design, Setting, and Participants: This 12-month (August 1, 2009, to August 31, 2010) case-control study with a prospective, observational, cross-sectional design recruited 47 consecutive patients with HS entering a tertiary care center and 45 healthy control individuals matched for age, sex, and body mass index (BMI). One patient and 4 controls failed to complete the questionnaire and were excluded from the evaluation. Data analysis was performed from December 1, 2013, to February 15, 2014. Main Outcomes and Measures: The Frankfurt Body Concept Scale (FKKS) and the Hospital Anxiety and Depression Scale (HADS) were given to patients and controls. Correlations among FKKS, HADS, and disease features were calculated. Results: Of the 46 patients and 41 controls included in the evaluation (mean [SD] age, 35.6 [1.6] years; 40 [46%] male and 47 [54%] female), HS significantly reduced body image (mean FKKS score, 234.2 [5.4] in patients and 276.9 [5.7] in controls; P < .001), even when controlled for BMI. A correlation was found for the extent of body image disruption and BMI (r = -0.589; P < .001), HADS-depression score (r = -0.619; P < .001), and HADS-anxiety score (r = -0.340; P = .03). No association was found for the body image score and the severity of HS, age at onset of disease, and duration of disease. The body contact subscale score was the only subscale score that was not different between patients with HS and controls. Conclusions and Relevance: Patients with HS have major body image impairment, which might lead to depression and anxiety, disorders that have been largely acknowledged in HS. This study identified another element of the psychosocial burden of patients with HS and reveals that body image could potentially be used as an outcome measure in future studies of HS. SN - 2168-6084 UR - https://www.unboundmedicine.com/medline/citation/29466546/Association_of_Hidradenitis_Suppurativa_With_Body_Image_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2017.6058 DB - PRIME DP - Unbound Medicine ER -