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

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 healthcare 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<0.001). A higher proportion of Black/AA females than White females with HS had BMI in the obese range (69.9% vs 56.5%; P=0.03). In contrast, fewer Black/African American males with HS had a BMI in the obese range compared to White males (51.4% vs. 61.0%; P<0.001). More Black/AA patients than White patients with HS had congestive heart failure (OR=2.10, CI=1.19-3.78; P<0.05), chronic pulmonary disease (OR=1.34; CI=1.02-1.78; P<0.05), diabetes with chronic complication (OR=1.73; CI=1.16-2.60; P<0.05), renal disease (OR=2.66; CI=1.67-4.34; P<0.05), and Charlson Comorbidity Index score ≥4 (OR=1.67; CI=1.09-2.58; P<0.05). Furthermore, male patients were more likely than female patients to have renal disease (OR=2.62; CI 1.66-4.14; P<0.05).

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.