Systemic inflammation correlates with depression and lower quality of life in patients with hidradenitis suppurativa independent of disease severity

Hidradenitis suppurativa (HS) is associated with a cumulative life course impairment and patients commonly present with signs of depression and anxiety. This study aimed to investigate the association between systemic inflammation, measured by laboratory markers, and psychological burden, evaluated using specific psychometric scores, in patients with HS. The study also evaluated the impact of treatment initiation on inflammatory biomarkers and psychometric scores. A prospective, observational, monocentric study was conducted on adult patients with HS of Hurley stage I, II and III, who were eligible for treatment initiation. Disease severity was assessed using the Hurley stage, and disease activity through the IHS4 scoring system. Laboratory evaluation of systemic inflammation included measurement of White Blood Cell count, Erythrocyte Sedimentation Rate (ESR) and C-reactive protein levels, at the study onset, right before treatment initiation, at 12 weeks and at 24 weeks following treatment onset. The impact of the disease on psychological status and overall quality of life was evaluated through psychometric scores. Our results indicate that systemic inflammation, reflected by laboratory inflammatory markers such as ESR, is associated with a higher probability of depression, loneliness and reduced quality of life independently of Hurley stage, severity score, and clinical characteristics such as gender and smoking status. Psychometric evaluation, including the presence of depression and loneliness in HS patients, independent of Hurley stage is advisable, especially in cases where serum inflammatory markers, such as ESR, are high.