New Study Raises Questions About Hidradenitis Suppurativa Diagnostic Criteria in Pediatric Patients

By Tamara Thomas - March 6, 2023

Existing diagnostic criteria for hidradenitis suppurativa (HS) may not fully apply to pediatric patients, as they may experience disease recurrence less frequently than required by these criteria, according to study findings published in JAMA Dermatology.

Nicole Kittler and colleagues at the University of California, San Francisco, analyzed electronic medical records of 297 adolescent patients with HS to find out what proportion of pediatric patients with hidradenitis suppurativa (HS) meet existing consensus-derived HS diagnostic criteria.

The Researchers noted that while there are established diagnostic criteria for hidradenitis HS derived from consensus to aid in accurate clinical diagnosis for adult patients, they have yet to be evaluated for use in pediatric patients. This finding is surprising, given that most HS cases occur during adolescence.

“Consequences of diagnostic delay for patients with HS of all ages include possible disease progression and delayed medical and procedural interventions. In addition, diagnostic delay hinders screening and treatment of HS-associated comorbidities and functional and social impairment,” the authors wrote.

Of the patients in the study, about 123 were female. Seventy-eight of these patients self-identified as black, and 116 self-identified as Hispanic.

The researchers found that about 57% of patients met all three major diagnostic criteria required for diagnosis. Approximately 43% met only some criteria, primarily due to not meeting the recurrence interval criterion.

Further review showed that many patients who did not initially meet the recurrence interval criterion had additional lesions consistent with HS. However, a significant proportion met the recurrence interval criterion after diagnosis.

Additionally, the study found that patients diagnosed with HS by a pediatric dermatologist were more likely to meet all the major diagnostic criteria than non-dermatologists.

“Because pediatric patients with HS present to various specialties, increasing awareness of HS beyond the dermatology setting is key to minimizing diagnostic delay and delayed therapy,” said the study authors.

The researchers concluded that future studies are needed to determine if revisions to the diagnostic criteria are necessary for timely diagnosis in pediatric patients.

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