OBJECTIVES: The objective of this research was to characterize demographics, disease severity, treatment, and associated comorbidities among pediatric hidradenitis suppurativa (HS) patients in diverse healthcare delivery settings in the United States (US).

METHODS: Patients from 6 specialty dermatology networks and 2 integrated delivery networks within the OMNY Health Database with any indication of HS (diagnosis code: L73.2) aged ≤ 18 from 2012-2021 were included. Demographic characteristics were tabulated at first HS diagnosis. Disease severity was characterized by the most severe stage. Percentages of patients with the following treatments were computed: topical clindamycin (TC), systemic antibiotics and immunomodulators (SAI), adalimumab, incision/drainage, excision, laser, and photodynamic therapy.

RESULTS: Across all years, 2,710 patients were included. Distribution of gender (81% female), race (58% white, 29% black, 13% other among known categories), and region (69% South, 16% Midwest, 12% West, 3% Northeast) were as expected. The mean (SD) age of the patient at the initial HS diagnosis was 15.32 (2.46). Among the 34% of patients with valid body mass index values, 45% were obese, 23% were overweight, and 32% were healthy/underweight. Disease severity (Hurley Stage) was documented in 18% of patients (42% stage 1, 46% stage 2, 12% stage 3). TC and SAI prescriptions were the most common treatment, representing 62% and 60% of patients, respectively, while adalimumab was prescribed to 5%. Laser surgery and incision/drainage procedures were performed in 6% and 4% of patients, respectively. Photodynamic therapy and excision procedures were negligible over the observation period. The most common comorbidities were acne (40%), pigmentation disorders (15%), and melanocytic nevi (15%).

CONCLUSION: Results provide insight into characteristics and treatments of pediatric HS within a diverse set of US healthcare settings. Acne presented as the most prevalent comorbidity. Future analyses would be helpful to determine patient journeys and burden of disease among pediatric HS patients.