Recognizing the Effects and Disparities of Pediatric Hidradenitis Suppurativa

Kirby, Joslyn S.; Zaenglein, Andrea L.

doi:10.1001/jamadermatol.2020.5434

Cited by 6 publications

(8 citation statements)

References 19 publications

(45 reference statements)

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“…Estimates of HS prevalence vary between 0.03% and 4% among different populations [ 34 , 35 ]. Therefore, it has not been well defined if HS is a rare or a neglected disease [ 36 ]. Since rare variants are commonly responsible for disease appearance, herein, for analysis purposes only, we considered HS a rare skin condition (AF ≤ 0.01).…”

Section: Methodsmentioning

confidence: 99%

Transcriptome Meta-Analysis Confirms the Hidradenitis Suppurativa Pathogenic Triad: Upregulated Inflammation, Altered Epithelial Organization, and Dysregulated Metabolic Signaling

et al. 2022

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Hidradenitis suppurativa (HS) is an inflammatory skin condition clinically characterized by recurrent painful deep-seated nodules, abscesses, and sinus tracks in areas bearing apocrine glands, such as axillae, breasts, groins, and buttocks. Despite many recent advances, the pathophysiological landscape of HS still demands further clarification. To elucidate HS pathogenesis, we performed a meta-analysis, set analysis, and a variant calling on selected RNA-Sequencing (RNA-Seq) studies on HS skin. Our findings corroborate the HS triad composed of upregulated inflammation, altered epithelial differentiation, and dysregulated metabolism signaling. Upregulation of specific genes, such as KRT6, KRT16, serpin-family genes, and SPRR3 confirms the early involvement of hair follicles and the impairment of barrier function in HS lesioned skin. In addition, our results suggest that adipokines could be regarded as biomarkers of HS and metabolic-related disorders. Finally, the RNA-Seq variant calling identified several mutations in HS patients, suggesting potential new HS-related genes associated with the sporadic form of this disease. Overall, this study provides insights into the molecular pathways involved in HS and identifies potential HS-related biomarkers.

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Section: Methodsmentioning

confidence: 99%

Transcriptome Meta-Analysis Confirms the Hidradenitis Suppurativa Pathogenic Triad: Upregulated Inflammation, Altered Epithelial Organization, and Dysregulated Metabolic Signaling

et al. 2022

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“…11 Disease outcomes are both difficult to define and subjective in nature, as the assessment of disease flares is neither standardized nor validated. 12 Providers must also be cognizant of the scarring and fibrosis that occurs as a result of the inflammatory lesions of HS, as it may make active lesions more difficult to differentiate. 11 Perhaps one of the most significant burdens of HS is its psychological impact on pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…11 Perhaps one of the most significant burdens of HS is its psychological impact on pediatric patients. 12 Patients in this population are particularly susceptible to the adverse impacts of chronic illnesses, including skin disorders, which can disrupt the developmental period. 13 Patients with HS experience chronic pain and face significant challenges, including bullying, self-isolation, and negative thinking.…”

Section: Discussionmentioning

confidence: 99%

The management of pediatric hidradenitis suppurativa differs between dermatologic and non‐dermatologic providers: A retrospective review

Atherton,

Shope,

Andrews

et al. 2023

Pediatric Dermatology

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Background/ObjectivesThere is a paucity of pediatric hidradenitis suppurativa (HS) literature. The objective of this study was to characterize differences in management of pediatric HS patients by dermatology versus non‐dermatology clinicians.MethodsWe examined a retrospective cohort of 195 pediatric patients with HS seen at our institution (3/1/19–3/1/20). Two‐sample t‐tests and two‐proportion z‐tests were performed.ResultsA total of 76.1% of subjects were seen by dermatology at least once, and of these, 79.1% were referred. HS diagnosis was most often made by dermatology (36.6%), followed by pediatrics (21.6%). Patients managed by dermatology were significantly more likely to have used standard of care therapies (p < .001). Of dermatology‐managed patients, 19.7% were currently prescribed a biologic, as compared with zero patients not managed by dermatology. Those managed by dermatology were less likely to undergo surgical excision (13.3% vs. 25.5%, p = .04).ConclusionsOur results support increased likelihood of treatment escalation with medical management by dermatologists. Relatively high utilization of referral to dermatology exists, but with only moderate patient adherence. There is a need for improved access to dermatologic care and prospective studies to determine whether differences in specialty management translate to improved patient outcomes.

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“…32 Comorbidities are a common and important consideration in pediatric patients with HS. 33 The associated comorbidities are reported in up to 85% of HS pediatric population, including obesity, metabolic syndrome, inflammatory bowel and joint disease, anxiety, and depression. 34,35 It is unknown if earlier and more effective treatments impact comorbidities, but they are likely to mitigate the impact of HS on mental and physical health.…”

Section: Discussionmentioning

confidence: 99%

Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review

et al. 2021

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Background: There is currently at least 1 biologic (adalimumab) approved in North America for treatment of Hidradenitis Suppurativa in the pediatric population. However, no reviews or clinical trials have specifically analyzed the effectiveness and safety data of biologic use in this population. The objective of this systematic review is to identify and summarize the outcomes of biologic therapy in pediatric patients with HS. Methods: MEDLINE and EMBASE databases were used to conduct the search on Sept 18, 2020. Results: The 15 included studies consisted of 26 patients, with the mean age of 15 ± 2.3 years. Females accounted for 53.8% ( n = 14/26) of cases. The mean duration of HS prior to biologic initiation was 3.5 ± 2.9 years, with the majority having Hurley Stage II. The 26 patients received 34 biologics in total: 85.3% treated with TNF alpha inhibitors (adalimumab n = 17, infliximab n = 10, etanercept n = 1, unspecified n = 1), 5.9% with IL-12/23 inhibitors (ustekinumab n = 2), 5.9% with IL-1 inhibitors (i.e., anakinra n = 2) and 2.9% received IL-23 inhibitors (i.e., guselkumab n = 1) biologics. Of the 26 patients, 23.1% ( n = 6/26) experienced complete resolution (CR), 73.1% ( n = 19/26) experienced partial resolution (PR), and 3.8% ( n = 1/26) had no resolution outcomes reported. The time to resolution of HS lesions after biologic initiation ranged from 10 days to 11.5 months (mean: 5.1 months). No adverse events were reported in the studies. Conclusion: Although anti-TNF alpha were the most common biologics used for HS in pediatric cases, large-scale trials specific to pediatric patients with HS are needed to confirm these findings.

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Recognizing the Effects and Disparities of Pediatric Hidradenitis Suppurativa

Cited by 6 publications

References 19 publications

Transcriptome Meta-Analysis Confirms the Hidradenitis Suppurativa Pathogenic Triad: Upregulated Inflammation, Altered Epithelial Organization, and Dysregulated Metabolic Signaling

Transcriptome Meta-Analysis Confirms the Hidradenitis Suppurativa Pathogenic Triad: Upregulated Inflammation, Altered Epithelial Organization, and Dysregulated Metabolic Signaling

The management of pediatric hidradenitis suppurativa differs between dermatologic and non‐dermatologic providers: A retrospective review

Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review

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