Screening for Inflammatory Chronic Arthritis in Hidradenitis Suppurativa with Psoriatic Arthritis Uncluttered Screening Evaluation (PURE) Questionnaire.

INTRODUCTION

Considering the growing recognition of the association between hidradenitis suppurativa (HS) and spondyloarthritis, this study addresses a gap in clinical practice in HS consultation: the absence of a validated arthritis screening tool.

METHODS

Drawing on interdisciplinary collaboration between dermatology and rheumatology, we assayed a modified version of the PURE-4 tool: patient and dermatologist Psoriatic Arthritis Uncluttered Screening Evaluation-5 (p- and dPURE-5), adapted to reflect clinical features relevant to this population.

RESULTS

Of 214 HS patients, 125 (58.4%) were male, with a median age of 42 years (IQR 30-49). Buttock involvement was observed in 64 patients (29.9%) and was more common in males (35.7%) than in females (21.6%) (p = 0.26). Of the 214 patients, 82 (38.3%) answered negatively to all questions, while 118 (55.6%) answered positively to at least one question in the pPURE-5 but were later dismissed by the trained dermatologist after a more detailed interview. Finally, 14 patients (6.5%) were referred to Rheumatology due to a positive dPURE-5. Of these, 2 (14.3%) were diagnosed with inflammatory chronic arthritis, yielding a positive predictive value of 14.3%.

CONCLUSION

To conclude, the PURE-5 questionnaire appeared valuable for guiding anamnesis and facilitating rheumatology referrals. Even so, there is still a need for new and validated screening tools for detecting arthritis in the HS population.