Progression From Cutaneous Abscess to Hidradenitis Suppurativa: A Retrospective Analysis

Area of Science:

• Dermatology
• Clinical Medicine
• Epidemiology

Background:

• Hidradenitis suppurativa (HS) diagnosis is often delayed, leading to irreversible scarring and reduced quality of life.
• Early identification of HS is essential to mitigate long-term disease impact.
• Understanding diagnostic patterns can improve patient outcomes.

Purpose of the Study:

• To determine the frequency of later HS diagnosis in patients initially presenting with cutaneous abscesses.
• To analyze the time to HS diagnosis and associated demographic factors.
• To identify potential indicators for earlier HS detection.

Main Methods:

• Retrospective chart review of patients diagnosed with cutaneous abscesses between 2012 and 2023 at Atrium Health Wake Forest Baptist.
• Data collection included demographics, clinical history, abscess/lesion location, and HS diagnosis.
• Statistical analyses (chi-squared and t-tests) were used to compare patient groups.

Main Results:

• Out of 471 patients, 71 were diagnosed with HS, predominantly women (80.3%).
• HS patients showed a higher likelihood of abscesses in the axillae (35.6%), inframammary region (p < .0001), or inguinal folds (p = .005).
• Abscesses in these typical HS locations were significantly more common compared to non-HS boils (5.4%).

Conclusions:

• The varied presentation of HS complicates early and definitive diagnosis.
• Anatomical location of abscesses serves as a key indicator for identifying patients who may benefit from early HS intervention.
• Prompt recognition and treatment are vital for managing this debilitating condition.