A diverse hidradenitis suppurativa cohort: A retrospective cross-sectional study of 13,130 patients from a large US health care system database from 1995 to 2022

J Am Acad Dermatol. 2024 Nov 10:S0190-9622(24)03121-9. doi: 10.1016/j.jaad.2024.10.073. Online ahead of print.

Abstract

Background: Most epidemiological studies of hidradenitis suppurativa (HS) have described homogeneous patient populations.

Objective: To characterize demographics, modifiable health behaviors, and comorbidities of HS patients within a diverse cohort.

Methods: A retrospective cross-sectional study of 13,130 HS patients within a health care system was conducted.

Results: A female sex bias of ∼3:1 in all racial/ethnic subgroups was observed. Black/African American (AA) patients had a lower age at HS diagnosis than White patients (37.1 years vs 39.4 years, P < .001). A higher proportion of Black/AA females than White females with HS had body mass index in the obese range (69.9% vs 56.5%; P = .03). In contrast, fewer Black/AA males with HS had a body mass index in the obese range compared to White males (51.4% vs 61.0%; P < .001). More Black/AA patients than White patients with HS had congestive heart failure (odds ratio (OR) = 2.10, confidence interval (CI) = 1.19-3.78; P < .05), chronic pulmonary disease (OR = 1.34; CI = 1.02-1.78; P < .05), diabetes with chronic complication (OR = 1.73; CI = 1.16-2.60; P < .05), renal disease (OR = 2.66; CI = 1.67-4.34; P < .05), and Charlson comorbidity index score ≥4 (OR = 1.67; CI = 1.09-2.58; P < .05). Furthermore, male patients were more likely than female patients to have renal disease (OR = 2.62; CI = 1.66-4.14; P < .05).

Limitations: A single-center study.

Conclusion: Subgroups of HS patients had significant differences in demographics, risk factors, and comorbid conditions.

Keywords: comorbidity; demographics; epidemiology; hidradenitis suppurativa; risk factors; sex bias.