About 50% of patients likely to have hidradenitis suppurativa begin between 10 and 21 years of age. Little research has been done on how teens with the condition use care leading up to diagnosis and how they differ from adult patients with hidradenitis suppurativa. A study of JAMA dermatology provides much-needed information
The researchers conducted a retrospective cohort study using the MarketScan medical claims database to identify pediatric and adult patients who had hidradenitis suppurativa claims between January 2012 and December 2016. Health care uses studied included ambulatory care by discipline, emergency care claims, clinical claims, and concurrent diagnoses.
A total of 8,727 patients were included in the study: 1094 pediatric patients with a mean age of 14.3 years and 7,633 adult patients, with a mean age of 37.2 years. Both subcohorts were heavily female. In the quest for a diagnosis, the pediatric patients would likely see a variety of clinicians, including dermatologists, primary care physicians, emergency room workers, and pediatricians who would make the initial diagnoses of comedones and folliculitis. In addition, these patients had a high rate of general medical conditions and comorbid skin conditions such as acne vulgaris (558 [51.0%]), acne conglobata (503 [45.9%]), obesity (369 [33.7%]), and anxiety disorders (367 [33.6%]). Pediatric patients were also more likely to have hidradenitis suppurativa-specific emergency and emergency care claims than the adult patients (35.6% vs 28.2%; P < .001; and 18.1% vs. 13.4%; P < . 001; respectively). The mean costs per emergency claim were comparable between both groups ($413.27 versus $682.54; P = 0.18). Over 5 years, the majority of disease-specific costs consisted of clinical visits in both groups.
The researchers concluded that, although hidradenitis suppurativa is often treated on an outpatient basis, pediatric patients often use expensive care options. They urge clinicians to improve the recognition of hidradenitis suppurativa in pediatric patients to reduce those costs.
1. Hallock K, Mizerak M, Dempsey A, Maczuga S, Kirby J. Differences between children and adults with hidradenitis suppurativa. JAMA-dermatol. August 11, 2021. Epub before press. doi:10.1001/jamadermatol.2021.2865