P106 Hidradenitis suppurativa is associated with lower socioeconomic status using the MacArthur scale of subjective social status

Abstract Hidradenitis suppurativa (HS) is associated with lower socioeconomic status (SES). Previous studies in Europe, Australia and the USA identified that patients with HS are more likely to be unemployed and have lower mean incomes than the background population. Low SES is inextricably linked with poor health outcomes. The MacArthur scale of subjective social status is a simple ladder from 1 to 10 that describes perceived SES and is an even better predictor of health outcomes than objective measures of SES. Our aim was to evaluate SES in HS using the MacArthur scale and compare it with healthy controls. Patient recruitment took place in two dermatology clinics where all patients with HS were invited to participate in addition to an anonymous online survey distributed by HS patient-led organizations. Healthy control patients were recruited from a rapid-access lesion clinic. Statistical analysis was completed using Jamovi (version 2.0). Student’s t-test was used to compare means and Spearman’s test for correlation. We recruited 131 patients with HS with a mean age of 37.6 years and 82 healthy controls with a mean age of 48.7 years. Patients with HS were predominantly female (89.3%) as were healthy controls (62.2%). The mean (SD) MacArthur scale in the HS group was 4.85 (2.19) (range 1–10). It was higher in healthy control patients at 6.44 (1.36) (range 3–10; P < 0.001). In the HS cohort, the mean MacArthur scale was higher in employed patients (5.49 vs. 3.59; P < 0.001) and in patients who completed any education following school (5.19 vs. 4.12; P = 0.009). The MacArthur scale weakly but statistically significantly correlated with age (r = 0.158, P = 0.022) and was higher in male patients (6.14 vs. 5.27; P = 0.013). Owing to the influence of age and sex on the MacArthur scale, a group of 37 patients with HS with age- and sex-matched healthy controls was analysed. In this matched group, the mean MacArthur scale was lower in patients with HS (5.22 vs. 6.36; P = 0.018). This is the first study to assess SES in HS using the MacArthur scale of the subjective social status. Patients with HS had a significantly lower SES than healthy controls. The MacArthur scale accounted for both employment and education in the HS cohort. The ladder is easy to use and provides more information with regard to health outcomes than objective SES alone. Its use should be considered in HS research, particularly studies evaluating treatment response, disease and comorbidity outcomes.