{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T16:54:54Z","timestamp":1793984094779,"version":"4.8.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gemeinsamer Bundesausschuss","award":["01NVF18008"],"award-info":[{"award-number":["01NVF18008"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hidradenitis suppurativa (HS) is an inflammatory disease of the inverse skin regions that occurs in young women, in particular, and affects approximately 1% of the population. Outpatient care is often inadequate and usually cannot prevent progression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate in the EsmAiL (\u2018Evaluation eines strukturierten und leitlinienbasierten multmodalen Versorgungskonzepts f\u00fcr Menschen mit Akne inversa\u2019) trial whether an innovative care concept can decrease disease activity and burden, and improve patient satisfaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>EsmAiL was conducted as a two-arm, multicentre, prospective, randomized controlled trial that included 553 adults with HS. Inclusion criteria were a minimum of three inflammatory lesions and at least a moderate impact of the disease on quality of life. The control group (CG) remained under standard care, while patients in the intervention group (IG) were treated according to a trial-specific, multimodal concept. The primary endpoint was the absolute change in International Hidradenitis Suppurativa Severity Score System (IHS4).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 274 patients were randomized to the IG and 279 to the CG. Altogether, 377 attended the final assessment after 12\u2005months of intervention. Participants in the IG (n = 203) achieved a mean improvement in IHS4 of 9.3 points, while the average decrease in IHS4 in patients in the CG (n = 174) was 5.7 points (P = 0.003). Patients treated under the new care concept also reported a statistically significantly higher decrease in pain, Dermatology Life Quality Index and Hospital Anxiety and Depression Scale scores compared with those in the CG (P &amp;lt; 0.001). Patient satisfaction was also statistically significantly higher in the IG compared with the CG (P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The establishment of standardized treatment algorithms in so-called \u2018acne inversa centres\u2019 in the ambulatory setting has a substantial, positive impact on the course of HS and significantly improves patient satisfaction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljad135","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T10:09:33Z","timestamp":1683108573000},"page":"170-179","source":"Crossref","is-referenced-by-count":17,"title":["A centre-based ambulatory care concept for hidradenitis suppurativa improves disease activity, disease burden and patient satisfaction: results from the randomized controlled EsmAiL trial"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2957-074X","authenticated-orcid":false,"given":"Michael","family":"Schultheis","sequence":"first","affiliation":[{"name":"Department of Dermatology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Staubach","sequence":"additional","affiliation":[{"name":"Department of Dermatology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Nikolakis","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane , Dessau , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Schollenberger","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre for Clinical Trials, University Medical Center, Johannes Gutenberg University , Mainz , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie\u00a0","family":"Mauch","sequence":"additional","affiliation":[{"name":"German Society for Wound Healing and Wound Treatment (DGfW) , Giessen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Burckhardt","sequence":"additional","affiliation":[{"name":"German Society for Wound Healing and Wound Treatment (DGfW) , Giessen , Germany"},{"name":"Baden-Wuerttemberg Cooperative State University, School of Business and Health , Stuttgart , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Heise","sequence":"additional","affiliation":[{"name":"Institute for Health and Nursing Science"},{"name":"Institute of General Practice and Family Medicine"},{"name":"Profile Centre of Health Sciences Halle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Zamsheva","sequence":"additional","affiliation":[{"name":"Institute for Health and Nursing Science"},{"name":"Profile Centre of Health Sciences Halle"},{"name":"Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty, Martin Luther University Halle-Wittenberg , Halle , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra\u00a0","family":"Strobel","sequence":"additional","affiliation":[{"name":"Profile Centre of Health Sciences Halle"},{"name":"Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty, Martin Luther University Halle-Wittenberg , Halle , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gero","family":"Langer","sequence":"additional","affiliation":[{"name":"Institute for Health and Nursing Science"},{"name":"Profile Centre of Health Sciences Halle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falk","family":"Bechara","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology, and Allergology, St Josef Hospital, Ruhr-University Bochum , Bochum , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Kirschner","sequence":"additional","affiliation":[{"name":"Dermatology Outpatient Office Dr. Uwe Kirschner , Mainz , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Hennig","sequence":"additional","affiliation":[{"name":"Department of Dermatology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kunte","sequence":"additional","affiliation":[{"name":"Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik M\u00fcnchen , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Goebeler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, University Hospital W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6863-8719","authenticated-orcid":false,"given":"Stephan","family":"Grabbe","sequence":"additional","affiliation":[{"name":"Department of Dermatology and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"issue":"Suppl. 5","key":"2023122117343291200_ljad135-B1","first-page":"S1","article-title":"[S1 guideline for the treatment of hidradenitis suppurativa\/acne inversa* (number ICD-10 L73.2)]","volume":"10","author":"Zouboulis","year":"2012","journal-title":"J Dtsch Dermatol 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