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Prescribing Patterns in Pediatric Hidradenitis Suppurativa
Hannah Neimy1,2, Courtney L Walker3, Lara Wine Lee3
1College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Insights
Treatment for pediatric hidradenitis suppurativa (HS) varies by disease severity. More severe HS cases (Hurley stage III) received biologics, intralesional steroids, and pain management more frequently than milder cases (Hurley stage I).
Area of Science:
- Dermatology
- Pediatric Medicine
- Inflammatory Diseases
Background:
- Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition.
- Increasing diagnosis rates in pediatric populations highlight a need for understanding treatment patterns.
- Limited data exists on HS treatment practices specifically in children and adolescents.
Purpose of the Study:
- To analyze treatment variations in pediatric hidradenitis suppurativa based on disease severity.
- To identify specific therapies more commonly used in severe pediatric HS cases.
Main Methods:
- Retrospective study analyzing data from 163 pediatric patients (age ≤ 18) diagnosed with HS.
- Comparison of treatment modalities across different Hurley stages (I, II, III) of the disease.
- Statistical analysis to determine significant differences in treatment patterns based on disease severity.
Main Results:
- Treatment patterns for pediatric HS significantly correlate with disease severity (Hurley stage).
- Patients with Hurley stage III HS were more likely to receive biologics, chlorhexidine, intralesional steroids, metformin, oral steroids, and spironolactone compared to Hurley stage I.
- Higher Hurley stages were associated with increased prescriptions for pain management, including NSAIDs and opioids.
Conclusions:
- Disease severity is a key determinant of treatment selection in pediatric hidradenitis suppurativa.
- More aggressive therapies and pain management are utilized in more severe pediatric HS cases.
- Further research is warranted to optimize HS management strategies in pediatric patients.
Abstract:
Hidradenitis suppurativa (HS) is an inflammatory skin condition increasingly diagnosed in pediatric populations; however, data on treatment practices in this group remains limited. In this retrospective study of 163 patients diagnosed with HS ≤ 18 years of age, we found that treatment patterns varied significantly by disease severity. As compared to patients with Hurley stage I (HSI) disease, those with Hurley stage III (HSIII) were more likely to receive: biologics (11.8% versus 58.3%, p < 0.001), chlorhexidine (47.1% versus 75.0%, p = 0.009), intralesional steroid injections (20.0% versus 58.3%, p < 0.001), metformin (3.53% versus 22.2%, p = 0.006), oral steroids (0%, versus 19.4%, p < 0.001), and spironolactone (10.6% versus 38.9%, p = 0.001). Higher Hurley stage was also associated with higher odds of receiving pain management prescriptions (NSAIDs [10.6% HSI versus 26.2% Hurley stage II (HSII) versus 52.8% HSIII; p < 0.001] and opioids [3.6% HSI versus 9.3% HSII versus 31.0% HSIII; p < 0.001]).
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