Journal of cutaneous medicine and surgery · 2026
Clinical Characteristics and Management of Pediatric Hidradenitis Suppurativa: A Canadian Single-Centre Multidisciplinary Experience.
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Dienes Serena, Rahmani Arya, Lara-Corrales Irene, Levy Rebecca, Alhusayen Raed, Barnett Amy, Croitoru David, George Ralph, Hamilton Jill, Johnson Kirsti, Joseph Marissa, Palmer Latoya, Mirza Reza, Piguet Vincent, Sangha Nimrita, Liy Wong Carmen, Sibbald Cathryn
Аннотация
BACKGROUND: Hidradenitis suppurativa (HS) is a highly comorbid condition understudied in pediatric populations. Furthermore, the underrepresentation of Canadians in HS research limits our evaluation of care in real-world Canadian settings.
OBJECTIVES: To describe the demographics, clinical characteristics, psychosocial burden, and management of pediatric HS at a Canadian hospital.
METHODS: We developed the infrastructure for a Canada-wide HS registry and piloted it at a pediatric HS tertiary care centre. A retrospective review of patients seen was performed using data collection forms (DCFs) developed for the registry.
RESULTS: The 39 patients included were 53.8% female and 100.0% nonsmokers. Asians were overrepresented compared to other North American studies. Most had Hurley stage II (60.5%) or III (28.9%) disease. Mean delay to diagnosis was 2.1 ± 2.0 years. Obesity (57.9%), acne (30.7%), folliculitis (23.1%), and trisomy 21 (23.1%) were the most common comorbidities. Patients with trisomy 21 had an age of HS onset 3 years younger (P = .0087), and 44.0% had concomitant disseminate and recurrent infundibulofolliculitis. Moderate-to-severe quality of life (QOL) impact was seen in 56.8% of patients, and 17.6% had reported bullying. Of patients prescribed biologics (59.0%), most used 1 (56.6%), while 39.1% switched to a second and 4.3% to a third biologic. Most adalimumab-initiated patients clinically improved (81.0%), but only 2 patients achieved complete remission. Follow-up patients (n = 14) had significant improvements in QOL (P = .038) and pain (P = .026) scores.
CONCLUSIONS: Distinct demographics, severe disease, and low remission rates characterized our complex HS cohort. Prospective use of these DCFs will enhance our understanding of HS in Canada.
OBJECTIVES: To describe the demographics, clinical characteristics, psychosocial burden, and management of pediatric HS at a Canadian hospital.
METHODS: We developed the infrastructure for a Canada-wide HS registry and piloted it at a pediatric HS tertiary care centre. A retrospective review of patients seen was performed using data collection forms (DCFs) developed for the registry.
RESULTS: The 39 patients included were 53.8% female and 100.0% nonsmokers. Asians were overrepresented compared to other North American studies. Most had Hurley stage II (60.5%) or III (28.9%) disease. Mean delay to diagnosis was 2.1 ± 2.0 years. Obesity (57.9%), acne (30.7%), folliculitis (23.1%), and trisomy 21 (23.1%) were the most common comorbidities. Patients with trisomy 21 had an age of HS onset 3 years younger (P = .0087), and 44.0% had concomitant disseminate and recurrent infundibulofolliculitis. Moderate-to-severe quality of life (QOL) impact was seen in 56.8% of patients, and 17.6% had reported bullying. Of patients prescribed biologics (59.0%), most used 1 (56.6%), while 39.1% switched to a second and 4.3% to a third biologic. Most adalimumab-initiated patients clinically improved (81.0%), but only 2 patients achieved complete remission. Follow-up patients (n = 14) had significant improvements in QOL (P = .038) and pain (P = .026) scores.
CONCLUSIONS: Distinct demographics, severe disease, and low remission rates characterized our complex HS cohort. Prospective use of these DCFs will enhance our understanding of HS in Canada.