The management of pediatric hidradenitis suppurativa differs between dermatologic and non-dermatologic providers: A retrospective review

Pediatr Dermatol. 2024 Jan-Feb;41(1):28-33. doi: 10.1111/pde.15466. Epub 2023 Nov 28.

Abstract

Background/objectives: There is a paucity of pediatric hidradenitis suppurativa (HS) literature. The objective of this study was to characterize differences in management of pediatric HS patients by dermatology versus non-dermatology clinicians.

Methods: We examined a retrospective cohort of 195 pediatric patients with HS seen at our institution (3/1/19-3/1/20). Two-sample t-tests and two-proportion z-tests were performed.

Results: A total of 76.1% of subjects were seen by dermatology at least once, and of these, 79.1% were referred. HS diagnosis was most often made by dermatology (36.6%), followed by pediatrics (21.6%). Patients managed by dermatology were significantly more likely to have used standard of care therapies (p < .001). Of dermatology-managed patients, 19.7% were currently prescribed a biologic, as compared with zero patients not managed by dermatology. Those managed by dermatology were less likely to undergo surgical excision (13.3% vs. 25.5%, p = .04).

Conclusions: Our results support increased likelihood of treatment escalation with medical management by dermatologists. Relatively high utilization of referral to dermatology exists, but with only moderate patient adherence. There is a need for improved access to dermatologic care and prospective studies to determine whether differences in specialty management translate to improved patient outcomes.

Keywords: hidradenitis suppurativa; management; outcomes; pediatric; therapy.

MeSH terms

  • Child
  • Hidradenitis Suppurativa* / diagnosis
  • Hidradenitis Suppurativa* / therapy
  • Humans
  • Patient Compliance
  • Prospective Studies
  • Retrospective Studies