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Hidradenitis suppurativa, which occurs in only 28 per 100,000 U.S. children and teens, is most common in African American and biracial girls aged 15-17 years, a study has found.

“The relatively low disease burden must not overshadow the extreme quality of life impact this disease has on those afflicted with it,” noted Amit Garg, MD, and associates at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hyde Park, N.Y.

Elsevier
The cross-sectional gender- and age-adjusted population analysis established an overall standardized point prevalence of 0.028%, occurring in 1,240 U.S. patients aged 0-17 years with hidradenitis suppurativa (HS) in a population of 4,578,790 for whom gender and age was known; the standardized prevalence was 28 per 100,000. Patients were classified into one of three age groups (0-9 years, 10-14 years, and 15-17 years) and one of five racial classifications (Caucasian alone, African American alone, Biracial [Caucasian and African American], other, and unknown).

The clinical term “hidradenitis’ was used to locate pediatric patients within a multi-institutional database of 55 million patients participating in 27 integrated health care organizations whose records were active in the database between March 2014 and March 2017.

The standardized prevalence of HS among girls was 3.75 times greater than in boys (P less than .0001), and the condition was most common in those aged 15-17 years (72%) across each racial group. “HS disproportionately affects African American children and adolescents, who have a 3.5-fold greater standardized prevalence than do Caucasians,” the authors wrote. The report was published in the Journal of Investigative Dermatology. Specifically, the highest prevalence by race was found in females aged 15-17 years who were African American (525 per 100,000) and biracial (253 per 100,000).

The authors acknowledged the availability of limited existing HS pediatric data from case reports and small series, none of which provided descriptions of subgroups by gender, age, or race.

In their review of the existing literature, Dr. Garg and his associates noted several key observations that may further aid in clinical diagnosis of pediatric patients at greater risk of developing HS:

 

 

  • HS appears most likely to be a post-adrenarche disease; children with the disease more frequently present with a hormonal imbalance compared with adults. In fact, HS in children may be a marker of precocious puberty, as noted in those presenting with adrenal hyperplasia and premature adrenarche.
  • A separate population-based analysis revealed an association between HS and polycystic ovary syndrome.
  • Pediatric patients diagnosed with HS are more likely to present with a family history of the condition, and those experiencing early onset appear likely to develop more widespread HS.
  • A fivefold likelihood of HS in pediatric Down syndrome patients is also attributed to genetic mutations.

The higher incidence of HS among adults (0.1%) is likely due to largely postpubertal disease onset, the authors speculated. They acknowledged that delays in diagnosing adolescent HS could account for the difference in prevalence between pediatric and adult populations. According to one study cited by Dr. Garg and his colleagues, adults with HS may have symptoms as many as 7 years prior to receiving a diagnosis.

Findings in Dr. Garg’s study serve to reinforce those of previous studies on adult HS populations, which also cited higher prevalence among females, especially African American females.

The research was funded by an unrestricted educational grant from AbbVie. Dr. Garg has served as an adviser for and received honoraria from AbbVie; the remaining researchers had no relevant financial disclosures.

SOURCE: Garg A et al. J Investig Dermatol. 2018 Apr 2. doi: 10.1016/j.jid.2018.04.001.

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Hidradenitis suppurativa, which occurs in only 28 per 100,000 U.S. children and teens, is most common in African American and biracial girls aged 15-17 years, a study has found.

“The relatively low disease burden must not overshadow the extreme quality of life impact this disease has on those afflicted with it,” noted Amit Garg, MD, and associates at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hyde Park, N.Y.

Elsevier
The cross-sectional gender- and age-adjusted population analysis established an overall standardized point prevalence of 0.028%, occurring in 1,240 U.S. patients aged 0-17 years with hidradenitis suppurativa (HS) in a population of 4,578,790 for whom gender and age was known; the standardized prevalence was 28 per 100,000. Patients were classified into one of three age groups (0-9 years, 10-14 years, and 15-17 years) and one of five racial classifications (Caucasian alone, African American alone, Biracial [Caucasian and African American], other, and unknown).

The clinical term “hidradenitis’ was used to locate pediatric patients within a multi-institutional database of 55 million patients participating in 27 integrated health care organizations whose records were active in the database between March 2014 and March 2017.

The standardized prevalence of HS among girls was 3.75 times greater than in boys (P less than .0001), and the condition was most common in those aged 15-17 years (72%) across each racial group. “HS disproportionately affects African American children and adolescents, who have a 3.5-fold greater standardized prevalence than do Caucasians,” the authors wrote. The report was published in the Journal of Investigative Dermatology. Specifically, the highest prevalence by race was found in females aged 15-17 years who were African American (525 per 100,000) and biracial (253 per 100,000).

The authors acknowledged the availability of limited existing HS pediatric data from case reports and small series, none of which provided descriptions of subgroups by gender, age, or race.

In their review of the existing literature, Dr. Garg and his associates noted several key observations that may further aid in clinical diagnosis of pediatric patients at greater risk of developing HS:

 

 

  • HS appears most likely to be a post-adrenarche disease; children with the disease more frequently present with a hormonal imbalance compared with adults. In fact, HS in children may be a marker of precocious puberty, as noted in those presenting with adrenal hyperplasia and premature adrenarche.
  • A separate population-based analysis revealed an association between HS and polycystic ovary syndrome.
  • Pediatric patients diagnosed with HS are more likely to present with a family history of the condition, and those experiencing early onset appear likely to develop more widespread HS.
  • A fivefold likelihood of HS in pediatric Down syndrome patients is also attributed to genetic mutations.

The higher incidence of HS among adults (0.1%) is likely due to largely postpubertal disease onset, the authors speculated. They acknowledged that delays in diagnosing adolescent HS could account for the difference in prevalence between pediatric and adult populations. According to one study cited by Dr. Garg and his colleagues, adults with HS may have symptoms as many as 7 years prior to receiving a diagnosis.

Findings in Dr. Garg’s study serve to reinforce those of previous studies on adult HS populations, which also cited higher prevalence among females, especially African American females.

The research was funded by an unrestricted educational grant from AbbVie. Dr. Garg has served as an adviser for and received honoraria from AbbVie; the remaining researchers had no relevant financial disclosures.

SOURCE: Garg A et al. J Investig Dermatol. 2018 Apr 2. doi: 10.1016/j.jid.2018.04.001.

 

Hidradenitis suppurativa, which occurs in only 28 per 100,000 U.S. children and teens, is most common in African American and biracial girls aged 15-17 years, a study has found.

“The relatively low disease burden must not overshadow the extreme quality of life impact this disease has on those afflicted with it,” noted Amit Garg, MD, and associates at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hyde Park, N.Y.

Elsevier
The cross-sectional gender- and age-adjusted population analysis established an overall standardized point prevalence of 0.028%, occurring in 1,240 U.S. patients aged 0-17 years with hidradenitis suppurativa (HS) in a population of 4,578,790 for whom gender and age was known; the standardized prevalence was 28 per 100,000. Patients were classified into one of three age groups (0-9 years, 10-14 years, and 15-17 years) and one of five racial classifications (Caucasian alone, African American alone, Biracial [Caucasian and African American], other, and unknown).

The clinical term “hidradenitis’ was used to locate pediatric patients within a multi-institutional database of 55 million patients participating in 27 integrated health care organizations whose records were active in the database between March 2014 and March 2017.

The standardized prevalence of HS among girls was 3.75 times greater than in boys (P less than .0001), and the condition was most common in those aged 15-17 years (72%) across each racial group. “HS disproportionately affects African American children and adolescents, who have a 3.5-fold greater standardized prevalence than do Caucasians,” the authors wrote. The report was published in the Journal of Investigative Dermatology. Specifically, the highest prevalence by race was found in females aged 15-17 years who were African American (525 per 100,000) and biracial (253 per 100,000).

The authors acknowledged the availability of limited existing HS pediatric data from case reports and small series, none of which provided descriptions of subgroups by gender, age, or race.

In their review of the existing literature, Dr. Garg and his associates noted several key observations that may further aid in clinical diagnosis of pediatric patients at greater risk of developing HS:

 

 

  • HS appears most likely to be a post-adrenarche disease; children with the disease more frequently present with a hormonal imbalance compared with adults. In fact, HS in children may be a marker of precocious puberty, as noted in those presenting with adrenal hyperplasia and premature adrenarche.
  • A separate population-based analysis revealed an association between HS and polycystic ovary syndrome.
  • Pediatric patients diagnosed with HS are more likely to present with a family history of the condition, and those experiencing early onset appear likely to develop more widespread HS.
  • A fivefold likelihood of HS in pediatric Down syndrome patients is also attributed to genetic mutations.

The higher incidence of HS among adults (0.1%) is likely due to largely postpubertal disease onset, the authors speculated. They acknowledged that delays in diagnosing adolescent HS could account for the difference in prevalence between pediatric and adult populations. According to one study cited by Dr. Garg and his colleagues, adults with HS may have symptoms as many as 7 years prior to receiving a diagnosis.

Findings in Dr. Garg’s study serve to reinforce those of previous studies on adult HS populations, which also cited higher prevalence among females, especially African American females.

The research was funded by an unrestricted educational grant from AbbVie. Dr. Garg has served as an adviser for and received honoraria from AbbVie; the remaining researchers had no relevant financial disclosures.

SOURCE: Garg A et al. J Investig Dermatol. 2018 Apr 2. doi: 10.1016/j.jid.2018.04.001.

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FROM THE JOURNAL OF INVESTIGATIVE DERMATOLOGY

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Key clinical point: Onset of HS prior to age 10 years is extremely rate; more than two-thirds of cases occurred in teens aged 15-17 years.

Major finding: HS rates among girls are almost four times higher than those of boys; more than 70% of cases occurred in teens aged 15-17 years.

Study details: Cross-sectional population analysis of 1,240 pediatric patients sampled from a database of 55 million unique records.

Disclosures: The research was funded by an unrestricted educational grant from AbbVie. Dr. Garg has served as an adviser for and received honoraria from AbbVie; the remaining researchers had no relevant financial disclosures.

Source: Garg A et al. J Invest Dermatol. 2018 Apr 2. doi: 10.1016/j.jid.2018.04.001.

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