Illness Acceptance in Patients with Hidradenitis Suppurativa Depends on Disease Severity and Psychosocial Parameters: An Observational Cross-Sectional Study.

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with substantial physical and psychosocial burden. Illness acceptance is an important component of adaptation to chronic disease, yet it remains underexplored in HS. Therefore, this study aimed to assess illness acceptance in HS patients. Methods: This cross-sectional study included 123 consecutive adult HS patients. Illness acceptance was assessed using the Acceptance of Illness Scale (AIS). Disease severity was evaluated using Hurley staging and the International Hidradenitis Suppurativa Severity Score System (IHS4). Pain and itch were measured using the Numeric Rating Scale. Quality of life (QoL) was assessed with the Dermatology Life Quality Index (DLQI) and Hidradenitis Suppurativa Quality of Life (HiSQoL). Depression and anxiety were evaluated using PHQ-9, GAD-7, and HADS. Results: The mean AIS score was 31 ± 8.7 points, with 14% of patients showing low and 24% moderate illness acceptance. Lower acceptance was associated with higher Hurley stage (p = 0.031). A significant negative correlation between AIS scores and IHS4 values was found (r = -0.26; p = 0.013). Additionally, AIS scores correlated negatively with pain (r = -0.22; p = 0.019) and itch (r = -0.23; p = 0.021). Strong negative correlations were found with QoL impairment (DLQI: r = -0.63; HiSQoL: r = -0.65; p < 0.001) and psychological distress, including depression (PHQ-9: r = -0.55; HADS-D: r = -0.60) and anxiety (GAD-7: r = -0.50; HADS-A: r = -0.56; p < 0.001 for all). Conclusions: Targeting illness acceptance may improve overall patient outcomes.