Perspectives on Pediatric Hidradenitis Suppurativa Care: A Survey of Pediatric Providers

Main Article Content

Rahul Masson
Terri Shih
Devea De
Swetha Atluri
Shahram Yazdani
Christopher J. Sayed
Vivian Y. Shi
Jennifer Lin Hsiao http://orcid.org/0000-0002-8843-3630

Keywords

hidradenitis suppurativa, pediatricians, medical education, providers' perspectives, survey

Abstract

 Background:  Hidradenitis suppurativa, or HS, is a chronic, inflammatory skin condition characterized by abscesses, nodules, and fistulas typically in intertriginous areas of the body. Pediatric providers are key front-line providers for children and adolescents with HS, yet little is known about their diagnostic and management approach.


Objective: In this survey study, we elicited the perspectives and experiences of pediatric providers regarding HS care.


Methods: An anonymous survey was distributed to pediatric providers through online pediatric organizational listservs. Survey questions addressed providers’ perspectives on HS diagnosis and management. Comparative statistics between survey responses and provider experience were performed using t-tests and a p-value <0.05 was considered significant.


Results: Among the 50 respondents, less than one-half were confident in knowing the available treatment options for HS (46%), managing mild HS (42%) or moderate-severe HS (6%), knowing pediatric HS comorbidities (30%), addressing challenges that HS patients face in school (22%), knowing when to discuss surgical treatments (20%), managing menstrual HS flares (14%), discussing the impact of HS on sexual health (14%), and managing patients with non-prescription therapies (0%). Of the 25 participants who saw patients with HS, less than two-thirds “often/sometimes” screened for substance abuse (64%), polycystic ovarian syndrome  (60%), premature adrenarche (28%), and inflammatory bowel disease (20%).


Conclusion: Educational resources targeted towards pediatric providers and increased collaboration with dermatologists may improve HS care for children and adolescents.

References

1. Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: A comprehensive review. Journal of the American Academy of Dermatology. 2009;60(4):539-561. doi:10.1016/j.jaad.2008.11.911

2. Hallock KK, Mizerak MR, Dempsey A, Maczuga S, Kirby JS. Differences Between Children and Adults With Hidradenitis Suppurativa. JAMA Dermatol. 2021;157(9):1095. doi:10.1001/jamadermatol.2021.2865

3. Liy-Wong C, Kim M, Kirkorian AY, et al. Hidradenitis Suppurativa in the Pediatric Population: An International, Multicenter, Retrospective, Cross-sectional Study of 481 Pediatric Patients. JAMA Dermatol. 2021;157(4):385-391. doi:10.1001/jamadermatol.2020.5435

4. Marzano AV, Genovese G, Casazza G, et al. Evidence for a ‘window of opportunity’ in hidradenitis suppurativa treated with adalimumab: a retrospective, real‐life multicentre cohort study*. Br J Dermatol. 2021;184(1):133-140. doi:10.1111/bjd.18983

5. Seivright JR, Collier E, Grogan T, Hogeling M, Shi VY, Hsiao JL. Physical and psychosocial comorbidities of pediatric hidradenitis suppurativa: A retrospective analysis. Pediatr Dermatol. 2021;38(5):1132-1136. doi:10.1111/pde.14765

6. Collier EK, Price KN, Grogan TR, Naik HB, Shi VY, Hsiao JL. Characterizing perimenstrual flares of hidradenitis suppurativa. International Journal of Women’s Dermatology. 2020;6(5):372-376. doi:10.1016/j.ijwd.2020.09.002

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