title: Pain management in patients with hidradenitis suppurativa.
abstract: Hidradenitis suppurativa (HS) is a chronic, relapsing, and painful inflammatory disease. HS patients' quality of life is severely impaired, and this impairment correlates strongly with their pain. Pain in HS can be acute or chronic and has both inflammatory and noninflammatory origins. The purpose of this review is to provide a summary of the existing literature regarding pain management in patients with HS. While there are no formal studies investigating pain management in HS, existing recommendations are based on general pain guidelines and expert opinion. Documentation of pain requires an assessment of the severity and timing of the pain. Although anti-inflammatory drugs and surgery for HS can alleviate pain, adjunctive pain medications are typically necessary. Topical analgesics, oral acetaminophen, and oral nonsteroidal anti-inflammatory drugs are considered first-line agents for the treatment of pain in patients with HS. If pain management is ineffective with those agents, oral opiates can be considered. In addition, anticonvulsants and selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors possess neuropathic pain-relieving properties that offer not only control of HS-associated pain but beneficial effects on itch and depression. There is clearly a need for additional studies on pain management in patients with HS.
authors.affiliation: Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: b.horvath@umcg.nl.
authors.forename: Barbara
authors.initials: B
authors.lastname: Horváth
authors.affiliation: Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Ineke C
authors.initials: IC
authors.lastname: Janse
authors.affiliation: Division of Dermatology, Department of Medicine, Faculties of Medicine and Public Health, University of Toronto, Toronto Regional (Dermatology) and Wound Healing Clinic, Mississauga, Ontario, Canada.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Sibbald
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D017497:Hidradenitis Suppurativa / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000187:drug effects*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen
keywords: anti-inflammatory drugs; hidradenitis suppurativa; pain management; quality of life; topical analgesics