Determining Typical Lesion Terminology for Hidradenitis Suppurativa

Five international hidradenitis suppurativa (HS) experts assessed a series of 25 photos representing typical HS lesions to establish a validated glossary of terms allowing the best possible description of lesions observed in HS patients. The results were published in Dermatology.

For each photo, the experts were asked whether naming of the lesions was possible or not and, if yes, by using which noun. Agreement of their responses was calculated using Fleiss's kappa index. Using a Delphi strategy, photos with disagreement were discussed, and photos were reevaluated on the next day.
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After the first round of photos, agreement between the experts was poor with a kappa index of only 0.33 (95% Confidence Interval [CI]; 0.22-0.46). After extensive discussion of cases with disagreement, the kappa index increased on day 2 to 0.75 (95% CI; 0.60-0.87), allowing for conclusions on good interobserver agreement on terminology. In addition, the researchers identified several clinical situations in which naming with established semantics is so far not possible. For these situations, the terms ‘multicord’, ‘multipore’, ‘multitunnel’ and ‘retraction’ were defined and included in the glossary.

This first validation of clinical terms used to describe lesions in patients with HS should be helpful in better defining the clinical phenotypes observed in this disorder, the researchers concluded.

Reference

Lipsker D, Severac F, Freysz M, Sauleau E, Boer J, Emtestam L et al. The ABC of Hidradenitis Suppurativa: A Validated Glossary on how to Name Lesions.

Reference:
The precise clinical description of skin lesions observed in some patients with hidradenitis suppurativa (HS) can be extremely difficult. Dermatology. 2016;232(2):137-42.