A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

Joslyn Sciacca Kirby, B. Moore, P. Leiphart, K. Shumaker, A. Mammis-Gierbolini, F. Benhadou, V. del Marmol

Research output: Contribution to journalArticle

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Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory condition that can have periodic worsening or flares. Measurement of flare is important because it can inform treatment efficacy; however, it is unclear how HS flare should be defined. Objectives: This study reviewed the literature for definitions of HS flare. Methods: The PubMed MEDLINE online database was searched on 10 January 2018 and the search was repeated on 8 December 2018 for new publications. Titles and abstracts were screened for inclusion. Subsequently, full articles were screened for inclusion. Papers were included if the publication was a systematic review, clinical trial, cohort study, case report or series, or cross-sectional study. Studies were excluded if they were journalistic reviews, did not discuss clinical findings of HS or did not use the words ‘flare’, ‘exacerbation’, ‘relapse’ or ‘recurrence’. Results: Two hundred and seventy-four papers were identified and 154 fulfilled the study criteria. Of these, 27 (17.5%) included the term ‘flare’ and 16 (10.4%) included the term ‘exacerbation’. Two of the 27 papers (7%) defined the term flare and both included patient report of changes in symptoms or signs. One of 16 papers (6%) defined exacerbation, which was taken as one new HS lesion. The terms ‘recurrence’ and ‘relapse’ were more apt to be defined: 13% (13 of 100) and 14% (six of 44), respectively. Conclusions : The lack of a specific and measurable definition of HS flare is a barrier to assessment of this important outcome. Once a specific and measurable definition is established, validated and reliable measures of HS flare can be incorporated into future studies.

Original languageEnglish (US)
JournalBritish Journal of Dermatology
DOIs
StateAccepted/In press - Jan 1 2019

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Hidradenitis Suppurativa
Recurrence
PubMed
MEDLINE
Signs and Symptoms
Publications
Cohort Studies
Cross-Sectional Studies
Outcome Assessment (Health Care)
Clinical Trials
Databases

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

Sciacca Kirby, J., Moore, B., Leiphart, P., Shumaker, K., Mammis-Gierbolini, A., Benhadou, F., & del Marmol, V. (Accepted/In press). A narrative review of the definition of ‘flare’ in hidradenitis suppurativa. British Journal of Dermatology. https://doi.org/10.1111/bjd.18035
Sciacca Kirby, Joslyn ; Moore, B. ; Leiphart, P. ; Shumaker, K. ; Mammis-Gierbolini, A. ; Benhadou, F. ; del Marmol, V. / A narrative review of the definition of ‘flare’ in hidradenitis suppurativa. In: British Journal of Dermatology. 2019.
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A narrative review of the definition of ‘flare’ in hidradenitis suppurativa. / Sciacca Kirby, Joslyn; Moore, B.; Leiphart, P.; Shumaker, K.; Mammis-Gierbolini, A.; Benhadou, F.; del Marmol, V.

In: British Journal of Dermatology, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Sciacca Kirby, Joslyn

AU - Moore, B.

AU - Leiphart, P.

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AU - Benhadou, F.

AU - del Marmol, V.

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N2 - Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory condition that can have periodic worsening or flares. Measurement of flare is important because it can inform treatment efficacy; however, it is unclear how HS flare should be defined. Objectives: This study reviewed the literature for definitions of HS flare. Methods: The PubMed MEDLINE online database was searched on 10 January 2018 and the search was repeated on 8 December 2018 for new publications. Titles and abstracts were screened for inclusion. Subsequently, full articles were screened for inclusion. Papers were included if the publication was a systematic review, clinical trial, cohort study, case report or series, or cross-sectional study. Studies were excluded if they were journalistic reviews, did not discuss clinical findings of HS or did not use the words ‘flare’, ‘exacerbation’, ‘relapse’ or ‘recurrence’. Results: Two hundred and seventy-four papers were identified and 154 fulfilled the study criteria. Of these, 27 (17.5%) included the term ‘flare’ and 16 (10.4%) included the term ‘exacerbation’. Two of the 27 papers (7%) defined the term flare and both included patient report of changes in symptoms or signs. One of 16 papers (6%) defined exacerbation, which was taken as one new HS lesion. The terms ‘recurrence’ and ‘relapse’ were more apt to be defined: 13% (13 of 100) and 14% (six of 44), respectively. Conclusions : The lack of a specific and measurable definition of HS flare is a barrier to assessment of this important outcome. Once a specific and measurable definition is established, validated and reliable measures of HS flare can be incorporated into future studies.

AB - Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory condition that can have periodic worsening or flares. Measurement of flare is important because it can inform treatment efficacy; however, it is unclear how HS flare should be defined. Objectives: This study reviewed the literature for definitions of HS flare. Methods: The PubMed MEDLINE online database was searched on 10 January 2018 and the search was repeated on 8 December 2018 for new publications. Titles and abstracts were screened for inclusion. Subsequently, full articles were screened for inclusion. Papers were included if the publication was a systematic review, clinical trial, cohort study, case report or series, or cross-sectional study. Studies were excluded if they were journalistic reviews, did not discuss clinical findings of HS or did not use the words ‘flare’, ‘exacerbation’, ‘relapse’ or ‘recurrence’. Results: Two hundred and seventy-four papers were identified and 154 fulfilled the study criteria. Of these, 27 (17.5%) included the term ‘flare’ and 16 (10.4%) included the term ‘exacerbation’. Two of the 27 papers (7%) defined the term flare and both included patient report of changes in symptoms or signs. One of 16 papers (6%) defined exacerbation, which was taken as one new HS lesion. The terms ‘recurrence’ and ‘relapse’ were more apt to be defined: 13% (13 of 100) and 14% (six of 44), respectively. Conclusions : The lack of a specific and measurable definition of HS flare is a barrier to assessment of this important outcome. Once a specific and measurable definition is established, validated and reliable measures of HS flare can be incorporated into future studies.

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