Hidradenitis suppurativa patients follow-up in reference centre during COVID-19 pandemic

Abstract

Introduction Teleconsultations are gaining popularity in many parts of the medicine. In addition, ongoing virtual ambulatory follow-up for Hidradenitis suppurativa (HS) patients is vital to minimize the risk of infection, especially for those patients with severe comorbidities. A global and European HS COVID-19 registries are being developed but data on virtual monitoring of HS patients are still lacking. Material and Methods HS patients from the local registry were consulted virtual at the European reference network for rare and complex diseases of the skin (ERN-Skin) centre. During the phone call, all patients were asked about the temperature, cough, dyspnoea. Patients who had active lesions were questioned by using the European HS registry follow-up questionnaire. The time of the consultation were recorded. Also, at the end of the consultation, patients were offered to performed polymerase chain reaction (PCR) COVID-19 test. In total, 10 patients were included. All data were collected by using RedCap software and discursive statistical analysis was performed by using IBM SPPS 26. Results 5/10 of subjects were male and 5/10 were female. As comorbidities, obesity was diagnosed in 4/10, arterial hypertension in 2/10, diabetes mellitus in 1/10, myopathy in 1/10 case and 1/10 patient had history of rectal cancer. In average the consultation took 12 min 24 sec. All patients denied fever, caught, dyspnoea or contact with positive COVID-19 patient. Follow-up questionnaire was filled in 8/10 cases and in average it took 8 min. 46 sec. 2/10 patients were smokers. Lesions were located in right axilla (3/8), left axilla (3/8), right groin (3/8), left groin (3/8), right external genitalia (2/8), left external genitalia (2/8) and in other locations (3/8). 7/8 and 1/8 patients were identified as Hurley II and III stage respectively. Mean of dermatology life quality index was 8.25±2.63 and mean of the pain was 5.71±2.06. Local treatment was prescribed in 6/8 cases and long term systemic antibiotics were prescribed in 3/8 cases. 3/10 patients agreed to perform a PCR COVID test and all results were negative. Other patients refused to take the test because they were afraid to visit hospital during pandemic (5/7), due to not having a transport (1/7) and because of family disapproval (1/7). Discussion As HS patients have many comorbidities, it is important to create a safe environment for their consultation during the global outbreak. Currently, a follow-up European registry questionnaire is an appropriate tool for virtual monitoring. Finally, it is important to identified asymptomatic COVID-19 cases and specialists during teleconsultation should encourage patients to perform PCR tests at least at drive-in testing stations by the place of residence.