Screening for Inflammatory Chronic Arthritis in Hidradenitis Suppurativa with Psoriatic Arthritis Uncluttered Screening Evaluation (PURE) Questionnaire.

Abstract

Introduction: Considering the growing recognition of the association between hidradenitis suppurativa (HS) and spondyloarthritis, this study addresses a gap in clinical practice in HS consultation: the absence of a validated arthritis screening tool.

Methods: Drawing on interdisciplinary collaboration between dermatology and rheumatology, we assayed a modified version of the PURE-4 tool: patient and dermatologist Psoriatic Arthritis Uncluttered Screening Evaluation-5 (p- and dPURE-5), adapted to reflect clinical features relevant to this population.

Results: Of 214 HS patients, 125 (58.4%) were male, with a median age of 42 years (IQR 30-49). Buttock involvement was observed in 64 patients (29.9%) and was more common in males (35.7%) than in females (21.6%) (p = 0.26). Of the 214 patients, 82 (38.3%) answered negatively to all questions, while 118 (55.6%) answered positively to at least one question in the pPURE-5 but were later dismissed by the trained dermatologist after a more detailed interview. Finally, 14 patients (6.5%) were referred to Rheumatology due to a positive dPURE-5. Of these, 2 (14.3%) were diagnosed with inflammatory chronic arthritis, yielding a positive predictive value of 14.3%.

Conclusion: To conclude, the PURE-5 questionnaire appeared valuable for guiding anamnesis and facilitating rheumatology referrals. Even so, there is still a need for new and validated screening tools for detecting arthritis in the HS population.