Hidradenitis Suppurativa Is Associated with Severe Sexual Impairment

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the pilosebaceous unit, often affecting and deforming intimate regions. HS is associated with severe pain, pruritus, and constant, purulent, malodorous discharge expected to impair sexual health of patients. Methods: We performed a cross-sectional, multicentric study involving 199 German patients from the health services research project "Epidemiology and Care in Acne inversa (EpiCAi)." The sexual health, HS severity, and quality of life of the studied group were evaluated using a specially designed questionnaire. Results: Regardless of gender, HS has an enormous impact on patients' sexual health. The patients scored, on average, 28.8 +/- 5.3 points on the Relation and Sexuality Scale (RSS). Multiple linear regression revealed that females and patients with Hurley III stage had higher sexual dysfunction (p = 0.012). Sexual dysfunction is associated with pain (beta = 0.25), the number of active lesions, the affected areas (beta = 0.14), and psychosocial aspects, including low quality of life (beta = 0.404), stigmatization (beta = 0.411), depression (beta = 0.413), and anxiety (beta = 0.300). Patients already see a substantial decrease in sexual frequency in the early stages of HS, while functional impairment and fear increase with the severity of the disease. Conclusion: Sexual health and management of its dysfunctions should be part of a holistic approach to HS patients.