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Multicenter Study
. 2021 Apr 1;157(4):385-391.
doi: 10.1001/jamadermatol.2020.5435.

Hidradenitis Suppurativa in the Pediatric Population: An International, Multicenter, Retrospective, Cross-sectional Study of 481 Pediatric Patients

Carmen Liy-Wong  1 , Mary Kim  2 , A Yasmine Kirkorian  3 , Lawrence F Eichenfield  4   5 , Lucia Z Diaz  6   7 , Amir Horev  8 , Megha Tollefson  9 , Teresa Oranges  10 , Roderic Philips  11   12 , Yvonne E Chiu  2 , Ghazal Ghafari  13 , Justin D Arnold  3 , Jessica Sprague  4   5 , Henry Nguyen  9 , Stephanie Wan  1 , Eshetu G Atenafu  14 , Elena Pope  1 , Jill Hamilton  15 , Haley B Naik  13 , Irene Lara-Corrales  1
Affiliations
Multicenter Study

Hidradenitis Suppurativa in the Pediatric Population: An International, Multicenter, Retrospective, Cross-sectional Study of 481 Pediatric Patients

Carmen Liy-Wong et al. JAMA Dermatol. .

Abstract

Importance: Hidradenitis suppurativa (HS) in pediatric patients has been understudied. Increased awareness and recognition of HS prevalence in children demand efforts to better understand this condition.

Objective: To describe the demographics, clinical features, treatment, associated comorbidities, and outcomes in a large cohort of pediatric patients with HS.

Design, setting, and participants: International, multicenter, retrospective medical record review of pediatric patients (aged 1-18 years) with a clinical diagnosis of HS carried out in 10 dermatology clinics across the US, Canada, Israel, Australia, and Italy from January 1996 to January 2017.

Main outcomes and measures: Patient demographics, clinical features, severity, associated comorbidities, and treatments in pediatric patients with HS.

Results: This cross-sectional study included 481 patients diagnosed with HS. Overall, 386 (80%) were girls. The mean (SD) age of disease onset was 12.5 (2.9) years, and the mean (SD) age at diagnosis was 14.4 (3.5) years. Family history of HS was present in 111 of 271 (41%) patients. First signs/symptoms reported at disease onset were cyst/abscess in 229 of 481 (48%), pain/tenderness in 118 of 481 (25%), and papules/pustules in 117 of 481 (24%). At initial dermatologic assessment, 233 of 481 (48%) patients already had evidence of skin scarring. Disease severity (Hurley staging) was documented in 288 of 481 (60%) patients (47% stage 1, 45% stage 2 and 8% stage 3). Comorbid conditions were reported in 406 of 481 (85%) patients, the most common being obesity (263/406 [65%]) and acne vulgaris (118/406 [29%]). Complications occurred in 378 of 481 (79%) patients, the most common of which were scars or contractures (301/378 [80%]).

Conclusions and relevance: The findings of this study indicate that there is a gap in recognizing and diagnosing pediatric HS. Pediatric patients with HS are likely to present with other comorbidities. Prospective observational and interventional studies are needed to better understand clinical course and optimal treatments for pediatric HS.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Lara-Corrales reports grants from AbbVie Investigator initiated study, supported by AbbVie grant during the conduct of the study; speaker’s fees and advisory board membership from Sanofi board, advisory board membership in Eli Lilly and Novartis Advisory, grants from L'Oréal Dermatologist of the Heart Award, and consulting fees from Pierre Fabre, Avicanna Consultant, Janssen Consultant, and Pfizer outside the submitted work. Dr Horev reports fees from the Hospital for Sick Children–Toronto Data Extraction time reimbursement during the conduct of the study. Dr Naik reports grants from AbbVie, personal fees from AbbVie, personal fees from DAVA Oncology, personal fees from 23andme, and personal fees from Boehringer Ingelheim during the conduct of the study. Dr Oranges reports that research in this publication was supported in part by an AbbVie grant (institutions that contributed more than 20 patients received a stipend for data collection), but his institution (the Universita di Pisa) in Italy did not receive any funding for this study. The content of this publication is solely the responsibility of the authors. This project was a result of collaboration from the Pediatric Dermatology Research Alliance). Dr Pope reports grants from AbbVie during the conduct of the study; and advisory board meetings for Novartis, Sanofi, and Janssen. No other disclosures are reported.

Comment in

References

    1. Saunte DML, Jemec GBE. Hidradenitis suppurativa: advances in diagnosis and treatment. JAMA. 2017;318(20):2019-2032. doi:10.1001/jama.2017.16691 - DOI - PubMed
    1. Naik HB, Paul M, Cohen SR, Alavi A, Suàrez-Fariñas M, Lowes MA. Distribution of self-reported hidradenitis suppurativa age at onset. JAMA Dermatol. 2019;155(8):971-973. doi:10.1001/jamadermatol.2019.0478 - DOI - PMC - PubMed
    1. Lindsø Andersen P, Kromann C, Fonvig CE, Theut Riis P, Jemec GBE, Holm JC. Hidradenitis suppurativa in a cohort of overweight and obese children and adolescents. Int J Dermatol. Published online September 19, 2019. - PubMed
    1. Shalom G, Cohen AD. The epidemiology of hidradenitis suppurativa: what do we know? Br J Dermatol. 2019;180(4):712-713. doi:10.1111/bjd.17249 - DOI - PubMed
    1. Ingram JR, Jenkins-Jones S, Knipe DW, Morgan CLI, Cannings-John R, Piguet V. Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. Br J Dermatol. 2018;178(4):917-924. doi:10.1111/bjd.16101 - DOI - PubMed

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