British Association of Dermatologists Guidelines for the Management of Hidradenitis Suppurativa (Acne Inversa) 2018

J.R. Ingram; F. Collier; D. Brown; T. Burton; J. Burton; M.F. Chin; N. Desai; T.E.E. Goodacre; V. Piguet; A.E. Pink; L.S. Exton; M.F. Mohd Mustapa


The British Journal of Dermatology. 2019;180(5):1009-1017. 

In This Article

Recommended Audit Points

1. In the last 20 consecutive patients diagnosed with HS is there evidence of:

   (a) provision of a patient information leaflet?

   (b) an offer of smoking-cessation referral, where relevant?

   (c) an offer of weight-management referral, where relevant?

   (d) screening for comorbidities?

      • depression

      • anxiety

      • cardiovascular risk factors (e.g. diabetes, hypertension, hyperlipidaemia and central obesity)

   (e) documentation of baseline disease stage (mild, moderate, severe, based on Hurley system)?

   (f) documentation of disease severity using recognized instruments, including quality of life and pain?

   (g) a pre-operative discussion for those undergoing surgery, covering duration of recovery and wound care?

2. In the last 20 consecutive patients with HS receiving adalimumab therapy:

  1. was a baseline count of inflammatory nodules, abscesses and draining sinus tracts performed?

  2. was there documentation of a Hurley score of II or III in at least one skin region?

  3. was there documentation of contraindication(s) or failure to respond to conventional systemic therapy?

  4. was treatment discontinued if there was a reduction of less than 25% in the baseline total abscess and inflammatory nodule count or any increase in abscesses or draining sinuses?

The audit recommendation of 20 cases per department is to reduce variation in the results due to a single patient and to allow benchmarking between different units. However, departments unable to achieve this recommendation may choose to audit all cases seen in the preceding 12 months.