British Association of Dermatologists (BAD) National Clinical Audit on the Management of Hidradenitis Suppurativa (HS) in the UK.

The first UK guidelines for the management of hidradenitis suppurativa (HS) were published by the British Association of Dermatologists (BAD) in 2018. The guidelines contained a set of audit criteria.To evaluate current HS management against the audit standards in the BAD guidelines.BAD members were invited to complete audit questionnaires between January and May 2020 for five consecutive HS patients per department.Eighty-eight centres participated, providing data for 406 patients. Disease staging using the Hurley system and disease severity using a validated tool during follow-ups were documented in 75% and 56%. Quality of life (QoL) and pain were documented in 49% and 50%. Screening for cardiovascular disease risk factors was as follows: smoking 75%, body mass index (BMI) 27% and others such as lipids and diabetes 57%. Screening for depression and anxiety was performed in 40% and 25%. Support for smokers or obese patients was documented in 35% and 23%. One hundred eighty-two patients were on adalimumab, of whom 68% had documentation of baseline disease severity, and 76% documented inadequate response or contraindications to systemic treatments. Forty-four percent of patients continued on adalimumab despite having less than 25% improvement in lesion count.UK dermatologists performed well against several audit standards, including documenting disease staging at baseline and smoking status. However, improvements are needed, particularly with regard to screening and management of comorbidities that could reduce the long-term complications associated with HS. A re-audit is required to evaluate changes in practice in the future.

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