Clinical characteristics of pediatric hidradenitis suppurativa: a cross-sectional multicenter study of 140 patients

Abstract

Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases.

Pediatric Hidradenitis Suppurativa: A Cross-Sectional Study on Clinical Features and Treatment Approaches

“…14 Other studies on pediatric HS reported sex, family history, and "early" or prepubertal-onset disease as relevant factors impacting on disease severity, extent of involvement, and clinical distribution of lesions. 15,16 We report a large pediatric cohort of HS patients, describing clinical characteristics, comorbidities and treatment patterns, further confirming a disease continuum with the adult patient group. Female preponderance (female:male ratio 3.6-4 to 1) is remarkably higher in pediatric than in adultonset HS and has been reported in both international and national observational studies.…”

“…14 Other studies on pediatric HS reported sex, family history, and “early” or prepubertal-onset disease as relevant factors impacting on disease severity, extent of involvement, and clinical distribution of lesions. 15,16…”

Hidradenitis suppurativa in paediatric patients: a retrospective monocentric study in Germany and review of the literature

“…highlight that although only one out of five paediatric patients smoked actively, a passive tobacco exposure was documented by the rest of the patients. A current retrospective analysis from Riis et al 24 . showed that almost 50% of the paediatric patients were passive smokers.…”

The most recent advances in understanding and managing hidradenitis suppurativa

“…Generally, obesity was prominent in pediatric patients and was related to parent BMI, indicating that there may be benefit in implementing preventative measures in the whole family 18 . Lastly, the way in which disease was managed in pediatric patients was similar to that in adult patients, but younger patients more commonly exhibited milder disease 19 .…”