AISI: A New Disease Severity Assessment Tool for Hidradenitis Suppurativa

Introduction. Hidradenitis suppurativa (HS) is a chronic, disabling, skin disorder. Because of renewed scientific interest in HS, different aspects of the condition, such as disease severity assessment, are being investigated and better defined. The aim of this study is to provide a novel tool for the assessment of disease severity. Methods and Materials. An HS-tailored, composite, dynamic score, named the Acne Inversa Severity Index (AISI) was designed to include a physician-rated assessment that considers the type of lesions occurring and the affected body sites. Additionally, a 0-10 visual analog scale (VAS), named Illness-VAS, was created to assess a patients pain, discomfort, and disability due to HS. The authors compared AISI with other validated measurements, namely the Hurley staging classification, modified Sartorius score, and the Dermatology Life Quality Index (DLQI). Results. The AISI was tested in 46 patients with HS, demonstrating a significant correlation with Hurley staging (r: 0.70856; P ≤ 0.0021), modified Sartorius score (r: 0.9730; P ≤ less than 0.00001), and DLQI (r: 0.8257; P ≤ 0.0221). According to AISI cut-offs, HS may be defined as mild (AISI less than 10), moderate (AISI 10 > 18), and severe (AISI > 18). Additionally, comparing the 2 dynamic scores, AISI and Sartorius, AISI proved significantly faster than the Sartorius score (46.44 ± 19.24 seconds vs 83.2 ± 19.04 seconds; P ≤1.31 x 10-6). Conclusions. Being simple, fast, dynamic, and accurate, the AISI could represent the ideal measurement for HS severity in both real-life and clinical trial settings.