Hidradenitis Suppurativa Disease Severity and Outcomes Among Black Patients from Low-Income Neighborhoods at a Tertiary Care Hospital: A Retrospective Review

Abstract

Hidradenitis suppurativa (HS) is a debilitating, inflammatory condition of apocrine sweat glands. Black patients are disproportionately affected, a finding largely attributed to lower socioeconomic status (SES) in the literature; yet, most HS studies include majority White cohorts. We present, to our knowledge, the first retrospective review of an entirely Black patient population living in low-income neighborhoods diagnosed with hidradenitis suppurativa (HS) to identify potentially modifiable factors related to disease severity and outcomes. We reviewed charts of Black patients with an encounter for HS from 2010-2020 in the New Orleans University Medical Center database.  HSt III disease was associated with early and chronic onset, longer time-to-treatment, higher body mass index, and Medicaid insurance. Flared disease was associated with fewer dermatology visits, more incision and drainage procedures, and higher lost-to-follow-up rates while well-controlled patients had more surgical excisions, biologic use, and lower smoking rates. Patients were nearly evenly split among initial Hurley stages (HSt), and ~50% of the 473 patients were stable or well-controlled at latest disease status, suggesting low SES alone cannot explain HS race-based discrepancies. Our findings highlight potentially modifiable factors for healthcare providers to consider when holistically treating Black patients living in low-SES communities.