Hidradenitis suppurativa - Pharma goes digital to accelerate clinical drug development

Dina Hasarmi
Dina Hasarmi
Medical Writer

Hidradenitis suppurativa (HS) is an autoinflammatory skin condition affecting about 1% of the total population. Due to the characteristics of its symptoms, HS patients experience embarrassment and reluctance to visit the practitioner, therefore, treatment often starts when the disease is already far progressed. SCARLETRED delivers a technology which not only offers a time saving method for assessment, in comparison to the currently available scoring methods, but also via telemedical services, it ensures professional visual documentation from the patient's own home, hence, eliminating some of the psychological burden associated with the doctor’s visit. 


What is hidradenitis suppurativa?

Hidradenitis suppurativa is a lifelong, painful, autoinflammatory skin disease that cause abscesses and scarring on the skin. It is a recurring condition, requiring constant, stage-dependent management. HS often starts at puberty with a peak age of onset in the early twenties. The estimated prevalence rate is 1%, however, due to the psychological burden of the disease the actual prevalence of HS might be higher. 

The etiology of HS is unknown and the associated skin lesions occur near hair follicles, close to sweat glands, with predominant localization in the groin and armpits. Experts assume that the condition is connected to hormonal, genetic and immunological factors. 

Signs and symptoms of the disease include:

  • Blackheads
  • Painful lumps
  • Cysts
  • Fistules and sinuses
  • Scarring

HS comes with serious physical complications and psychological challenges. Next to the physical complications, such as scars and infection, patients face serious psychological conditions and social isolation, as the location, drainage and odor of the sores can cause embarrassment and reluctance to go out in public, which might lead to depression. 


Professionals are lacking standardized diagnostic tools

Due to the complexity of its presentation, there is no generally accepted method to evaluate the severity and progression efficiently. Hence, there is a need for straightforward and rapid assessment tools.

The currently used scoring systems struggle between trying to be easy to use or accurately descriptive. Three of them are described here as examples.

The Hurley system describes the distinct clinical stages of HS, allowing intuitive evaluation of HS, but it does not include the location and number of affected sites and does not reflect the inflammatory stage, thus other methods are necessary to determine the severity of HS in daily practice and in clinical research. 

Today, different alternative visual scoring methods are available for the assessment of the severity and extent of HS, among them are the broadly used Hidradenitis Suppurativa Physician Global Assessment (HS-PGA) and the International Hidradenitis Suppurativa Severity Score System (IHS4), however both methods show significant limitations. Both are difficult to use and can only be poorly standardized when used among different investigators, such as in multicentric clinical trials. Another aspect is that both methods are highly consuming and do show only a very low sensitivity with respect to small changes in the course of a treatment. 



New treatment options are on the way

HS comes with serious physical as well as psychological burden. HS patients often score high on the scale of dermatological quality of life (DQOL) index, implying that they experience a serious impairment of their QOL. HS has been alleviated for a long time and finding a curative treatment for HS was a clinical challenge, which biopharma companies and CROs are now focusing on. Up until now, treatment options were focused on preventing the disease from getting worse, forming additional scars and to control flares. In order to move research forward, the mechanism and the manifestation of the disease has to be well understood. Professionals are in need of a tool by which the diagnosis and assessment can be optimized, and which allows the easy and reliable documentation of the manifestation of the condition, providing useful information for biopharma companies and professionals.

A number of new medical treatments have emerged in recent years, which do not only address the symptoms of HS. Thus, having a digital technology that helps the development of new therapeutics for the treatment of HS is becoming more and more essential. 



Teledermatology for the assessment and treatment of HS

SCARLETRED´s skin imaging technology Scarletred®Vision (V3.0 and higher) enables high quality documentation and analysis of a wide variety of skin conditions. It delivers a digital solution that provides a standardized and objective visual documentation and analysis tool for the assessment of HS, thus overcoming the inaccuracies resulting from the subjectivity and lack of reliability of the currently available assessment tools. On the other hand, a standardized high quality photo documentation gives a tremendous advantage in the monitoring and follow-up of HS, contributing to defining the effectiveness of the treatment. Furthermore, it has the potential to reduce time efforts of the physician. 

The CE medical device certified technology of Scarletred®Vision is used in medical routine in HS already since 2017. The software complies with highest international regulations. It is well accepted by regulatory bodies for use in clinical trials globally, where it supports the development of new potential treatment options. Because of the psychological impact of HS, patients prefer to monitor their disease from home, instead of visiting the doctor. It allows the professional visual documentation from the patient's own home, which is particularly beneficial for Biopharma companies and doctors as it delivers an easy and time saving method pushing clinical trials quickly forward.

The Scarletred®Vision system consists of a mobile app, a web platform and skin patches, which can be easily applied even on sensitive skin types. The app together with the platform creates a secure data storage and information flow between HS patients and professionals. The real-time based visual documentation grants enhanced efficiency and reliability of the assessment and monitoring of HS. The platform functions as a secure documentation tool providing objective measurement and assessment of HS through the integrated remote data monitoring level and built-in customizable service tools, ensuring reliability and accuracy. 


HS is a lifelong condition with high disease burden. Due to the psychological impact of HS, patients might feel embarrassed to go to the doctor, therefore often treatment is first assigned when the disease is already far progressed. SCARLETRED´s technology delivers a digital solution for an easy and objective assessment tool for HS, ensuring early recognition, improving prognosis and beneficially impacts drug development. 

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