{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T21:50:55Z","timestamp":1774129855919,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The hidradenitis suppurativa (HS) clinical response (HiSCR) has come under scrutiny as several HS clinical trials failed to meet primary endpoints with high placebo responses. This may be due to limitations of the tool and raters' ability to accurately characterize and count lesions, rather than lack of efficacy of the studied drug. Due to HS lesion complexity and potential differences in rater training, it was hypothesized that there would be discrepancies in how providers characterize and count lesions for HS clinical trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate how HS providers and patients name and count HS lesions and to identify discrepancies among providers to initiate the development of consensus\u2010driven guidance for HS rater training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An online survey was distributed to the members of HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC). Respondents were asked to classify lesion images composed of multiple and different morphology types and answer questions regarding inclusion of associated dermatological conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010seven HISTORIC members responded (29 providers; 18 patients). There was variability in how respondents classified HS lesions. Of 12 questions containing images, four had \u226550% of respondents choosing the same answer. With an image of a lesion composed of different morphologies, 45% of providers counted it as a single lesion and 45% counted it as multiple distinct lesions. With an image of multiple interconnected draining tunnels, 7% of providers classified it as a single draining tunnel while 79% categorized it as multiple draining tunnels with the number estimated by visual inspection. There was also variability in deciding whether lesions occurring in associated conditions should be considered separately or included in HS lesion counts. Patient responses were also variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The result of the current study reaffirms the gap in how providers characterize and count HS lesions for clinical trials and the need to develop consensus\u2010driven rater training related to HS outcome measures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.19999","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T07:46:45Z","timestamp":1712735205000},"page":"210-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Discrepancies in hidradenitis suppurativa lesion characterization by providers and patients"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-8730","authenticated-orcid":false,"given":"Lindsey","family":"Greenlund","sequence":"first","affiliation":[{"name":"University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1016-438X","authenticated-orcid":false,"given":"Claire","family":"Herzog","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Wendland","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Minnesota Medical School  Minneapolis Minnesota USA"},{"name":"Department of Dermatology Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn","family":"Rypka","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School  Minneapolis Minnesota USA"},{"name":"Department of Dermatology University of Minnesota Medical School  Minneapolis Minnesota USA"},{"name":"Department of Dermatology Minneapolis Veterans 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bisma","family":"Khalid","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle A.","family":"Lowes","sequence":"additional","affiliation":[{"name":"Laboratory for Investigative Dermatology The Rockefeller University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0886-6856","authenticated-orcid":false,"given":"Amit","family":"Garg","sequence":"additional","affiliation":[{"name":"Northwell Health  New York New York USA"},{"name":"Department of Dermatology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-4169","authenticated-orcid":false,"given":"Angelo V.","family":"Marzano","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1646-2608","authenticated-orcid":false,"given":"Christos C.","family":"Zouboulis","sequence":"additional","affiliation":[{"name":"Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg  Dessau Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thrasyvoulos","family":"Tzellos","sequence":"additional","affiliation":[{"name":"Department of Dermatology Nordland Hospital Trust, NLSH Bod\u00f8  Bod\u00f8 Norway"},{"name":"Department of Clinical Medicine UiT The Arctic University of Norway  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