Racial Disparities in Hidradenitis Suppurativa Management at a Single Institution

Abstract

Background: Hidradenitis suppurativa (H/S) disproportionately affects African Americans. We describe those affected by this disease to evaluate potential racial disparities.

Methods: This retrospective review examined 1148 patients with H/S cared for by plastic surgery and/or dermatology. Analysis was performed between African Americans and non-African Americans (White, Hispanic, Asian, and other races).

Results: Most patients identified as women (76%) and African American (66%). Mean age across all patients was 36.3 years and mean body mass index was 36.1 kg/m². A total of 1936 cases of H/S were identified, and African Americans more commonly experienced H/S of the bilateral axilla (P < 0.001), buttocks (P < 0.001), bilateral breasts (P = 0.001), abdomen (P < 0.001), and thigh (P < 0.001) than their non-African American counterparts. African Americans were more likely to undergo medical management only (P < 0.001), and non-African Americans were more likely to undergo surgery for H/S (P < 0.001). There was no difference in the rate of resolution of symptoms across cohorts; however, African American patients reported higher rates of symptom improvement than non-African Americans (P < 0.001). Non-African Americans had more emergency room visits (75) and more hospitalizations (67) than African Americans, who had 47 emergency room visits and 41 hospitalizations, respectively (P = 0.01 and P = 0.05).

Conclusions: African Americans may face disparities in the management of this complex and often chronic disease course. It is important that those affected by H/S are managed by a multidisciplinary team to ensure optimal patient care.

Fig. 1.

Location of H/S across all patients, African Americans (AA), and non–African Americans (n-AA).