Dermatologic disorders

HS Flares Are Often Heralded by Prodromal Symptoms

The majority of patients with hidradenitis suppurativa (HS) experience prodromal symptoms heralding the eruption of HS lesions, according to the results of a recent survey.

While prodromal symptoms are often anecdotally mentioned, few formal investigations into prodromal symptoms in HS patients have been conducted.
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In order to further explore this issue, researchers administered an extensive questionnaire including questions on the frequency, type and time of occurrence of the prodromal symptoms, and the degree of certainty of the perceived association to 72 patients with HS.

Overall, 83.3% (n=60) reported experiencing 1 or more prodromal symptoms prior to the development of inflamed nodules or abscesses. These symptoms included fatigue (32%), malaise (23%), headache (11%), and nausea (2%). Localized symptoms included skin erythema (75%), paresthesia (63%), and itching (20%). Forty-five percent of participants indicated that the prodromes occurred more than 24 hours before eruption, while 20% indicated that they occurred 12-24 hours before eruption.

“Our data suggest that the majority of patients with HS experience prodromal symptoms, heralding a flare of their HS,” the researchers concluded. “The findings may give rise to important new treatment approaches for the management of HS.”

—Michael Potts


Ring HC, Theut Riis P, Zarchi K, Miller IM, Saunte DM, Jemec GB. Prodromal symptoms in hidradenitis suppurativa [published online February 14, 2017]. Clin Exp Dermatol. doi: 10.1111/ced.13025.