The dermatology and rheumatology service at Parc Taulí have started a pioneering project in the State of a shared consultation for patients suffering from hidradenitis suppurativa and arthritis, such as spondyloarthritis. This space is an initiative of the Dres. Patricia Garbayo Salmons and Dr. Mireia Moreno Martínez-Losa to avoid duplication of visits and medical tests, improve the quality of care and reduce users' trips to the hospital.
Hidradenitis suppurativa is a chronic inflammatory disease of the skin in which recurrent outbreaks of nodules, abscesses and fistulas appear that produce pain and/or itching, suppuration and bad smell, especially in areas of folds such as the armpits, groin, glutes or the genitals. On the other hand, spondyloarthritis is a group of diseases that have as a common nexus the pain and stiffness of different joints of the back and pelvis, although they can also affect other joints of the hands, feet or knees . Both share the fact that they are multifactorial and complex diseases that have environmental predisposing factors in common.
Different studies have shown a higher percentage of arthritis, such as spondyloarthritis, in patients with hidradenitis suppurativa compared to the general population, and vice versa. However, we still do not know how the confluence of hidradenitis suppurativa and arthritis influences. Given that both diseases are characterized by their marked inflammatory burden, it would be plausible that, as happens in other immune-mediated diseases, their interaction has an impact on the therapeutic response, the control of the disease and the quality of life of the patients.
Faced with this fact, Parc Taulí has started the joint work of the two dermatology and rheumatology services to guarantee comprehensive care, improving early diagnosis, prevention and treatment, through multidisciplinary care.
Since it went into operation on September 12, 33 patients have already been referred. It is expected that in the coming months new cases will be identified that can benefit from this specialized care. In these visits, an accurate diagnosis of patients suspected of either pathology will be carried out and follow-up and individualized treatment agreed between the specialists involved will be guaranteed. This proposal follows the model of the shared consultation of patients with psoriasis and psoriatic arthritis, already implemented more than 10 years ago in different hospitals, in which Parc Taulí was also a pioneer and reference for other units in the State.
From the dermatology and rheumatology service, they have evaluated this initiative very positively, as explained by Drs. Garbayo Salmons and Moreno Martínez-Losa who are convinced that this joint consultation "will improve care for these highly complex patients, as well as early diagnosis and quality of life for our patients". In addition, this structure will facilitate the development of lines of research focused on both diseases and coordinated by the Parc Taulí Research and Innovation Institute (I3PT).
How will patients be referred?
Parc Taulí is a benchmark in the care of patients with hidradenitis suppurativa throughout Catalonia. In addition, it has a spondyloarthritis unit accredited by the Sociedad Española de Calidad Asistencial (SECA). Professionals in these specialties will be referred to the high-complexity multidisciplinary unit when they meet the previously defined referral criteria.
During the consultation, the dermatology and rheumatology care professionals will identify which patients may have hidradenitis suppurativa or spondyloarthritis and refer them to the specialist consultation. If the diagnosis of hidradenitis suppurativa and arthritis is confirmed, joint follow-up can begin.
Background in the investigation of hidradenitis suppurativa
From September 2022, the dermatology service at Parc Taulí established a medical-surgical committee for patients with hidradenitis suppurativa. This commission meets bimonthly and is made up of medical and surgical specialists involved in the diagnosis and treatment of this disease at hospital level.
The professionals at Parc Taulí have been working to increase the visibility of hidradenitis through various training initiatives. For example, in April, the first Vallès Conference on the Comprehensive Approach to Hidradenitis Suppurativa was held, which attracted a wide audience of medical and nursing professionals from the Eastern and Western Vallès area.
In addition, the ESPOcat Group of the Catalan Society of Rheumatology, currently under the coordination of Dres. Mireia Moreno and Maria Aparicio, organized an interdisciplinary training session on hidradenitis suppurativa and its relationship with arthritis, especially spondyloarthritis, last June 15.
These initiatives are important to improve the understanding and treatment of this disease and to promote better coordination between healthcare professionals.
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