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Recent advances in hidradenitis suppurativa in pediatrics
C W Rundle, K N Price, M Hogeling
1Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR. vivian.shi.publications@gmail.com.
Insights
Hidradenitis suppurativa (HS) in children is under-researched, often diagnosed late, and linked to genetic and endocrine issues. Early diagnosis and new treatments are crucial for better outcomes in pediatric HS.
Area of Science:
- Dermatology
- Pediatrics
- Inflammatory Diseases
Background:
- Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with a significant burden.
- Literature on pediatric HS is limited, necessitating a review of recent advancements.
Purpose of the Study:
- To systematically review recent literature on pediatric HS, focusing on epidemiology, presentation, comorbidities, and management.
- To highlight the current state of knowledge and identify gaps in pediatric HS research.
Main Methods:
- A systematic review of articles published between January 2015 and October 2019.
- Databases searched included PubMed, Embase, Google Scholar, and Clinicaltrials.gov.
- 39 relevant articles on pediatric HS were included in the review.
Main Results:
- Pediatric HS may involve genetic, endocrine, and metabolic factors, with delayed diagnosis leading to poor outcomes.
- Similar lesion types and affected areas are observed in pediatric and adult HS.
- Common comorbidities include acne, obesity, inflammatory joint disease, Down syndrome, inflammatory bowel disease, and diabetes.
Conclusions:
- Current evidence suggests specific associations and comorbidities in pediatric HS, though treatment guidelines are lacking.
- Adalimumab is approved for older children, with other immunomodulators under investigation.
- Further research is essential to characterize pediatric HS, improve early diagnosis, and establish optimal management strategies.
Abstract:
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that can cause significant physical, mental, and socioeconomic burden. There remains a paucity of literature on HS in the pediatric population. This systematic review highlights recent advances in pediatric HS in epidemiology, presentation, comorbidities, and management. PubMed, Embase, Google Scholar, and Clinicaltrials.gov databases were used to identify trials and articles published on HS in pediatric patients between January 2015 and October 2019. A total of 39 articles were included. Current evidence suggests that pediatric onset HS may be associated with genetic factors along with endocrine and metabolic abnormalities. Delayed diagnosis in children with HS contributes to poor outcomes. Overall, children and adults with HS share similar lesion types and involved areas. Pediatric HS is associated with a number of comorbid conditions including acne, obesity, inflammatory joint disease, Down syndrome, inflammatory bowel disease, and diabetes. There are currently no pediatric treatment guidelines. Adalimumab is approved for the treatment of moderate-to-severe HS in children 12 and older. Other targeted immunomodulators and hormonal modulators are under investigation. Although the number of studies concerning HS are increasing, further investigation is warranted to better characterize HS, facilitate early diagnosis, and determine the best management for children.
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