Background
Patients with hidradenitis suppurativa (HS) experience fatigue, but no studies have yet examined the association between HS severity and fatigue intensity.

Objectives
To examine the possible association between HS severity and fatigue and identify fatigue subtypes present in patients with HS.

Methods
Adult patients with HS participated in a survey assessing fatigue using the Multidimensional Fatigue Inventory-20. Disease severity was determined by self-report.

Results
Data from 654 adult patients with HS were analysed and compared with 3,788 reference individuals from the general population. Total and subtype fatigue scores for patients with HS were significantly higher compared with the general population reference individuals and increased with higher HS severity, itch, pain, sleep, dermatology life quality index scores and lower socioeconomic status. The association between HS severity and increased fatigue scores remained statistically significant after adjustment for age, sex, and socioeconomic status.

Conclusions
Patients with HS had a significantly higher fatigue score compared with the general population reference individuals in a severity-dependent manner. A higher awareness of fatigue as a symptom in patients with HS is warranted.