Alexithymia affects patients with hidradenitis suppurativa

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that impairs patients' quality of life. Various psychiatric or psychological conditions have been associated with HS, however, no data are available on alexithymia, a psychological construct characterized by the inability to express, describe, and recognize feelings. OBJECTIVES: To assess the presence of alexithymia in HS patients. MATERIALS & METHODS: Demographic and clinical data from patients with HS were collected. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS)-20 questionnaire to define non-alexithymic subjects (scoring 20-50), borderline (possible) alexithymia subjects (scoring 51-60), and alexithymic subjects (scoring ≥61). The alexithymic personality trait is identified based on TAS-20 score ≥51. RESULTS: This multicentre study included 86 HS patients, 100 obese individuals, and 85 healthy control subjects. The mean TAS-20 score was significantly higher in the HS patient cohort (55.37 ±13.42) than in the control group (40.96±10.47) (p<0.001). Compared to the healthy and obese control groups, the prevalence of alexithymic personality trait in HS patients was 61.6% versus 21.95% and 32%, respectively (p<0.001). Of the HS patients, 37.2% were classified as alexithymic and 24.4% as borderline alexithymia. CONCLUSIONS: This is the first study in which an association between HS and alexithymia has been reported, expanding the spectrum of psychological disorders associated with HS.