J Loget1, C Saint-Martin2, P Guillem3, L Kanagaratnam2, P-A Becherel4, A Nassif5, A-C Fougerousse6, M Siham7, C Girard8, H Barthelemy9, G Chaby10, G Gabison11, J-L Perrot12, V Pallure13, N Beneton14, T Boye15, C Jacobzone16, E Begon17, P Bernard18, Z Reguiai19. 1. Service de dermatologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France; ResoVerneuil, France. Electronic address: jeffreyloget@gmail.com. 2. Unité d'aide méthodologique, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France. 3. ResoVerneuil, France; Service de chirurgie adulte, clinique du Val-d'Ouest, 39, chemin de la Vernique, 69130 Ecully, France. 4. ResoVerneuil, France; Service de dermatologie, hôpital privé d'Antony, Ramsay générale de santé, 27, avenue de la Providence, 92160 Antony, France. 5. ResoVerneuil, France; Service de dermatologie, institut Pasteur, 25-28, rue du Dr-Roux, 75015 Paris, France. 6. ResoVerneuil, France; Service de dermatologie, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France. 7. ResoVerneuil, France; Service de dermatologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, 125, rue de Stalingrad, 93000 Bobigny, France. 8. ResoVerneuil, France; Service de dermatologie, centre hospitalier universitaire de Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex, France. 9. ResoVerneuil, France; Cabinet libéral de dermatologie, 2, rue Soufflot, 89000 Auxerre, France. 10. ResoVerneuil, France; Service de dermatologie, centre hospitalier universitaire Amiens-Picardie site Nord, place Victor-Pauchet, 80054 Amiens cedex 1, France. 11. ResoVerneuil, France; Cabinet libéral de dermatologie, 32, avenue du Maréchal-de-Lattre-de-Tassigny, 94410 Saint-Maurice, France. 12. ResoVerneuil, France; Service de dermatologie, hôpital Nord, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. 13. ResoVerneuil, France; Service de dermatologie, centre hospitalier de Perpignan, 20, avenue du Languedoc, 66000 Perpignan, France. 14. ResoVerneuil, France; Service de dermatologie, centre hospitalier du Mans, 194, avenue Rubillard, 72037 Le Mans, France. 15. ResoVerneuil, France; Service de dermatologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France. 16. ResoVerneuil, France; Service de dermatologie, centre hospitalier de Bretagne Sud, 5, avenue de Choiseul, 56322 Lorient cedex, France. 17. ResoVerneuil, France; Service de dermatologie, hôpital René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France. 18. Service de dermatologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France. 19. ResoVerneuil, France; Service de dermatologie, polyclinique Courlancy, 38 bis, rue de Courlancy, 51100 Reims, France.
Abstract
OBJECTIVE: To provide physicians with an understanding of the factors behind significant delays in the diagnosis of hidradenitis suppurativa (HS) in France. PATIENTS AND METHODS: This prospective multicentre national study conducted from October 2015 to March 2016 included all patients consulting for HS. Patient data were collected by means of a standardized questionnaire. Univariate and multivariate analyses were conducted to collect factors associated with a significant time to diagnosis of at least 5.5years, defined as the period between the onset of initial clinical signs and the time of formal diagnosis. RESULTS: The 16 participating centres enrolled 312 patients (62% women), of average age 35years. The average age at onset of HS was 22years. Before formal diagnosis by a dermatologist (64% of cases), 170 (54%), 114 (37%) and 45 (15%) patients had previously consulted at least 3, 5 and 10 general physicians, respectively. The average time between the initial clinical signs of HS, the first dermatology visit and the definitive diagnosis was 6.2 and 8.4 years, respectively. Active smoking (OR adjusted 1.85; P=0.027) and disease onset at a younger age (adjusted OR 0.92; P<0.001) were both associated with significant delays in diagnosis. CONCLUSION: These results emphasized misdiagnosis among HS patients but did not evidence any association between either sociodemographic or economic characteristics and the existence of significant times to diagnosis.
OBJECTIVE: To provide physicians with an understanding of the factors behind significant delays in the diagnosis of hidradenitis suppurativa (HS) in France. PATIENTS AND METHODS: This prospective multicentre national study conducted from October 2015 to March 2016 included all patients consulting for HS. Patient data were collected by means of a standardized questionnaire. Univariate and multivariate analyses were conducted to collect factors associated with a significant time to diagnosis of at least 5.5years, defined as the period between the onset of initial clinical signs and the time of formal diagnosis. RESULTS: The 16 participating centres enrolled 312 patients (62% women), of average age 35years. The average age at onset of HS was 22years. Before formal diagnosis by a dermatologist (64% of cases), 170 (54%), 114 (37%) and 45 (15%) patients had previously consulted at least 3, 5 and 10 general physicians, respectively. The average time between the initial clinical signs of HS, the first dermatology visit and the definitive diagnosis was 6.2 and 8.4 years, respectively. Active smoking (OR adjusted 1.85; P=0.027) and disease onset at a younger age (adjusted OR 0.92; P<0.001) were both associated with significant delays in diagnosis. CONCLUSION: These results emphasized misdiagnosis among HS patients but did not evidence any association between either sociodemographic or economic characteristics and the existence of significant times to diagnosis.
Authors: Andreas Pinter; Georgios Kokolakis; Juergen Rech; Mona H C Biermann; Benjamin M Häberle; Jan Multmeier; Maximilian Reinhardt Journal: Dermatol Ther (Heidelb) Date: 2020-06-04