{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:49:28Z","timestamp":1790916568129,"version":"4.1.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF20SA0064340"],"award-info":[{"award-number":["NNF20SA0064340"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hidradenitis suppurativa (HS) is a chronic inflammatory and scarring disease with a wide spectrum of disease severity. The amount of scarring is proportional to the preceding tissue damage and poses a challenge to patients. Severe HS is most often treatment recalcitrant, but hypothetically avoidable through early biologic treatment. Early prediction of individual risk of disease progression is therefore essential for patient management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate risk factors associated with disease progression and to design an algorithm capable of predicting disease \u00adprogression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study of 335 Hurley III-na\u00efve patients with HS, not treated with biologics, was followed for a median of 2\u2005years. Potential risk factors covered basic demographics, HS anamnestic factors and clinical HS factors collected during physical examination. Two separate Cox proportional hazard regression (CPHR) analyses were conducted. A summated \u2018progression score\u2019 was calculated and used in the predictive algorithm of severe disease. Subsequent bootstrap sampling was used to validate the predictability of the predictive algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The CPHR analysis of Transition to severe disease found that active smoking [hazard ratio (HR) 4.01, 95% confidence interval (CI) 1.71\u20139.40, P = 0.001]; body mass index (BMI) points &amp;gt; 25 at baseline (each point: HR 1.06, 95% CI 1.02\u20131.09, P &amp;lt; 0.001); active disease in 2 (HR 4.26, 95% CI 1.23\u201314.84, P = 0.02) and \u2265 3 areas (HR 6.54, 95% CI 1.89\u201322.72, P = 0.003) all constituted substantial risk factors. Conversely, the CPHR analysis of Disease progression did not yield results of clinical relevance. A \u2018progression score\u2019 of 3.04 was used as a threshold in the predictive algorithm of Transition to severe disease and achieved the following test specifics: sensitivity = 0.51, specificity = 0.86, positive predictive value = 0.50, negative predictive value = 0.86.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found a disparity between factors increasing the risk of simple Disease progression and those increasing the risk of Transition to severe disease. For the latter, active smoking, BMI points &amp;gt; 25, active disease in 2 or \u2265 3 areas were all shown to be the clinically relevant factors that could be used to construct an algorithm that correctly predicted progression to severe HS in more than half of all instances.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljad530","type":"journal-article","created":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T08:43:10Z","timestamp":1704184990000},"page":"904-914","source":"Crossref","is-referenced-by-count":15,"title":["Initial steps towards developing a predictive algorithm of disease progression for hidradenitis suppurativa (HS): results from a Cox proportional hazard regression analysis on disease progression among a cohort of 335 Danish patients with HS"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0159-670X","authenticated-orcid":false,"given":"Rune","family":"Kj\u00e6rsgaard Andersen","sequence":"first","affiliation":[{"name":"Department of Dermatology, Zealand University Hospital, Roskilde, Denmark"},{"name":"Department of Immunology and Microbiology, Leo Foundation Skin Immunology Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2312-5976","authenticated-orcid":false,"given":"Ole","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen , Denmark"},{"name":"Department of Clinical Immunology, Zealand University Hospital , K\u00f8ge , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-8374","authenticated-orcid":false,"given":"Liv","family":"Eidsmo","sequence":"additional","affiliation":[{"name":"Department of Immunology and Microbiology, Leo Foundation Skin Immunology Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0712-2540","authenticated-orcid":false,"given":"Gregor","family":"Jemec","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Zealand University Hospital, Roskilde, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7953-1047","authenticated-orcid":false,"given":"Ditte","family":"Saunte","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Zealand University Hospital, Roskilde, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"2024051712193106900_ljad530-B1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1056\/NEJMcp1014163","article-title":"Clinical practice. Hidradenitis suppurativa","volume":"366","author":"Jemec","year":"2012","journal-title":"N Engl J Med"},{"key":"2024051712193106900_ljad530-B2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.21037\/atm-20-1028","article-title":"Hidradenitis suppurativa and psychiatric comorbidities, suicides and substance abuse: systematic review and meta-analysis","volume":"8","author":"Phan","year":"2020","journal-title":"Ann Transl Med"},{"key":"2024051712193106900_ljad530-B3","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.jaad.2017.10.001","article-title":"Demographic and health care service utilization by 4417 patients with hidradenitis suppurativa","volume":"77","author":"Shalom","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"2024051712193106900_ljad530-B4","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1111\/jdv.17148","article-title":"Convergent validity of suffering and quality of life as measured by the Hidradenitis Suppurativa Quality of Life","volume":"35","author":"Kursawe Larsen","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024051712193106900_ljad530-B5","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1111\/bjd.19626","article-title":"Hidradenitis suppurativa and perceived stigmatization in a diverse Canadian clinic population: a pilot study","volume":"184","author":"Bouazzi","year":"2021","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B6","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1093\/bjd\/ljac027","article-title":"The impact of hidradenitis suppurativa on professional life","volume":"188","author":"Schneider-Burrus","year":"2023","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B7","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1111\/bjd.16101","article-title":"Population-based clinical practice research datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa","volume":"178","author":"Ingram","year":"2018","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B8","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.jaad.2008.06.020","article-title":"Prevalence and factors associated with hidradenitis suppurativa: results from two case\u2013control studies","volume":"59","author":"Revuz","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"2024051712193106900_ljad530-B9","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ad.2011.07.008","article-title":"[Epidemiologic study of skin diseases among immigrants in Alicante, Spain]","volume":"103","author":"Albares","year":"2012","journal-title":"Actas Dermosifiliogr"},{"key":"2024051712193106900_ljad530-B10","doi-asserted-by":"crossref","first-page":"e0200683","DOI":"10.1371\/journal.pone.0200683","article-title":"Hidradenitis suppurativa (HS) prevalence, demographics and management pathways in Australia: a population-based cross-sectional study","volume":"13","author":"Calao","year":"2018","journal-title":"PLoS One"},{"key":"2024051712193106900_ljad530-B11","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/bjd.21234","article-title":"Prevalence of hidradenitis suppurativa in Berekum, Ghana","volume":"187","author":"Hagan","year":"2022","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jdin.2020.02.001","article-title":"Hidradenitis suppurativa prevalence in Berekum, Ghana: a cross-sectional study and initial validation of a questionnaire in an African setting","volume":"1","author":"Hagan","year":"2020","journal-title":"JAAD Int"},{"key":"2024051712193106900_ljad530-B13","doi-asserted-by":"crossref","first-page":"e392-4","DOI":"10.1111\/jdv.17933","article-title":"Prevalence and perceptions towards hidradenitis suppurativa: a cross-sectional study in a non-dermatological outpatient population","volume":"36","author":"Han","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024051712193106900_ljad530-B14","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/bjd.17101","article-title":"Impact of hidradenitis suppurativa on work loss, indirect costs and income","volume":"181","author":"Tzellos","year":"2019","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B15","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1111\/bjd.16998","article-title":"Prevalence of patients with self-reported hidradenitis suppurativa in a cohort of Danish blood donors: a cross-sectional study","volume":"180","author":"Theut Riis","year":"2019","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B16","doi-asserted-by":"crossref","first-page":"e712-14","DOI":"10.1111\/jdv.16536","article-title":"Emergency doctor\u2019s ability to diagnose hidradenitis suppurativa","volume":"34","author":"Bouazzi","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024051712193106900_ljad530-B17","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1001\/jamadermatol.2020.1281","article-title":"Disease trajectories for hidradenitis suppurativa in the Danish population","volume":"156","author":"Kj\u00e6rsgaard Andersen","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2024051712193106900_ljad530-B18","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1111\/bjd.14038","article-title":"Diagnostic delay in hidradenitis suppurativa is a global problem","volume":"173","author":"Saunte","year":"2015","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B19","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jaad.2019.06.1301","article-title":"Evaluating patients\u2019 unmet needs in hidradenitis suppurativa: results from the Global Survey of Impact and Healthcare Needs (VOICE) project","volume":"82","author":"Garg","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2024051712193106900_ljad530-B20","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.jaad.2019.12.024","article-title":"An internet-based survey study of patients with hidradenitis suppurativa: use of the internet for disease-related information","volume":"83","author":"Cole","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2024051712193106900_ljad530-B21","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.clindermatol.2016.10.018","article-title":"Treatments for hidradenitis suppurativa","volume":"35","author":"Andersen","year":"2017","journal-title":"Clin Dermatol"},{"key":"2024051712193106900_ljad530-B22","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1056\/NEJMoa1504370","article-title":"Two phase 3 trials of adalimumab for hidradenitis suppurativa","volume":"375","author":"Kimball","year":"2016","journal-title":"N Engl J Med"},{"key":"2024051712193106900_ljad530-B23","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S0140-6736(23)00022-3","article-title":"Secukinumab in moderate-to-severe hidradenitis suppurativa (SUNSHINE and SUNRISE): week 16 and week 52 results of two identical, multicentre, randomised, placebo-controlled, double-blind phase 3 trials","volume":"401","author":"Kimball","year":"2023","journal-title":"Lancet"},{"key":"2024051712193106900_ljad530-B24","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1093\/bjd\/ljad224","article-title":"Has the time come to assess small-molecule\/biologic drug combinations for the management of moderate-to-severe hidradenitis suppurativa?","volume":"189","author":"Maronese","year":"2023","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B25","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/bjd.18983","article-title":"Evidence for a \u2018window of opportunity\u2019 in hidradenitis suppurativa treated with adalimumab: a retrospective, real-life multicentre cohort study","volume":"184","author":"Marzano","year":"2021","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B26","first-page":"729","volume-title":"Dermatologic Surgery","author":"Hurley","year":"1989"},{"key":"2024051712193106900_ljad530-B27","doi-asserted-by":"crossref","first-page":"350","DOI":"10.2340\/00015555-1468","article-title":"Development of a clinical Scandinavian registry for hidradenitis suppurativa; HiSReg","volume":"93","author":"Ingvarsson","year":"2013","journal-title":"Acta Derm Venereol"},{"key":"2024051712193106900_ljad530-B28","article-title":"The effect of age on self-rated skin pain in patients with hidradenitis suppurativa","author":"Kj\u00e6rsgaard Andersen","year":"2021","journal-title":"Eur J Dermatol"},{"key":"2024051712193106900_ljad530-B29","doi-asserted-by":"crossref","first-page":"e827","DOI":"10.1111\/jdv.16704","article-title":"What counts? The relationship between patient estimated numbers of painful hidradenitis suppurativa lesions over 4 weeks compared with clinician\u2019s lesion count at the time of examination","volume":"34","author":"Kjaersgaard Andersen","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024051712193106900_ljad530-B30","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1136\/bmjebm-2018-111069","article-title":"Causal inference for clinicians","volume":"24","author":"Stovitz","year":"2019","journal-title":"BMJ Evid Based Med"},{"key":"2024051712193106900_ljad530-B31","first-page":"1887","article-title":"Robust causal inference using Directed Acyclic Graphs: the R package \u2018dagitty\u2019","volume":"45","author":"Textor","year":"2016","journal-title":"Int J Epidemiol"},{"key":"2024051712193106900_ljad530-B32","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/jdv.17857","article-title":"Incidence and remission rates of self-reported hidradenitis suppurativa \u2013 a prospective cohort study conducted in Danish blood donors","volume":"36","author":"Kjaersgaard Andersen","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024051712193106900_ljad530-B33","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1111\/bjd.13090","article-title":"Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: a cross-sectional study","volume":"171","author":"Kromann","year":"2014","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B34","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1111\/bjd.14024","article-title":"Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies","volume":"173","author":"Tzellos","year":"2015","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B35","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jaad.2019.10.044","article-title":"Hidradenitis suppurativa and smoking: a systematic review and meta-analysis","volume":"82","author":"Acharya","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2024051712193106900_ljad530-B36","author":"Wickham"},{"key":"2024051712193106900_ljad530-B37","author":"Therneau"},{"key":"2024051712193106900_ljad530-B38","author":"Kassambara"},{"key":"2024051712193106900_ljad530-B39","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/bjd.20654","article-title":"Evidence of gene\u2013gene interaction in hidradenitis suppurativa: a nationwide registry study of Danish twins","volume":"186","author":"Kjaersgaard Andersen","year":"2022","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B40","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1001\/jamadermatol.2020.3630","article-title":"Contribution of genetics to the susceptibility to hidradenitis suppurativa in a large, cross-sectional Dutch twin cohort","volume":"156","author":"van Straalen","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2024051712193106900_ljad530-B41","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/ced.14478","article-title":"Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity","volume":"46","author":"\u00d6zkur","year":"2021","journal-title":"Clin Exp Dermatol"},{"key":"2024051712193106900_ljad530-B42","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1159\/000491547","article-title":"Hurley III hidradenitis suppurativa has an aggressive disease course","volume":"234","author":"Vanlaerhoven","year":"2018","journal-title":"Dermatology"},{"key":"2024051712193106900_ljad530-B43","doi-asserted-by":"crossref","first-page":"553","DOI":"10.2340\/00015555-1800","article-title":"The influence of body weight on the prevalence and severity of hidradenitis suppurativa","volume":"94","author":"Kromann","year":"2014","journal-title":"Acta Derm Venereol"},{"key":"2024051712193106900_ljad530-B44","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1111\/bjd.15748","article-title":"Development and validation of the International Hidradenitis Suppurativa Severity Score System (IHS4), a novel dynamic scoring system to assess HS severity","volume":"177","author":"Zouboulis","year":"2017","journal-title":"Br J Dermatol"},{"key":"2024051712193106900_ljad530-B45","author":"Statistics Denmark"},{"key":"2024051712193106900_ljad530-B46","doi-asserted-by":"crossref","first-page":"adv00847","DOI":"10.2340\/actadv.v103.4410","article-title":"Hidradenitis suppurativa prevalence in Nuuk, Greenland: physician validation of a hidradenitis suppurativa questionnaire in a Greenlandic setting","volume":"103","author":"Botvid","year":"2023","journal-title":"Acta Derm Venereol"},{"key":"2024051712193106900_ljad530-B47","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1001\/jamadermatol.2017.0201","article-title":"Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States","volume":"153","author":"Garg","year":"2017","journal-title":"JAMA Dermatol"}],"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljad530\/57399805\/ljad530.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/190\/6\/904\/57725191\/ljad530.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/190\/6\/904\/57725191\/ljad530.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T08:24:04Z","timestamp":1715934244000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/article\/190\/6\/904\/7505345"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,3]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,1,3]]},"published-print":{"date-parts":[[2024,5,17]]}},"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljad530","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,1,3]]}}}