Being Black May Worsen Clinical Outcomes in HS

Black race may be a significant risk factor for more severe disease, increased hospitalization, and poorer clinical outcomes in patients with hidradenitis suppurativa (HS), according to a study published in the International Journal of Dermatology.

Caden Ulschmid and colleagues, of the Medical College of Wisconsin Department of Dermatology, conducted a retrospective study of 1190 patients seen at the Medical College of Wisconsin who had 3 more encounters for HS between January 2001 and March 2019. They investigated the associations of patient race and ethnicity with disease severity, emergency department (ED) visits, hospitalizations, and surgeries. Patients without race information or a treatment encounter for HS were omitted from the analysis.

The final study data included 953 patients, of which 49% (470) were Black, 4% (39) were Hispanic, 44% (418) were White non-Hispanic, and the remaining 3% (26) were another race or ethnicity.

After controlling for age, sex, BMI, tobacco use, and insurance type, the researchers found that Black patients, when compared with White patients, had 2.8 times the odds of having Hurley stage 3 disease (95% CI, 1.76-4.45; P<.001), 2.86 times the risk for experiencing an ED visit for HS (95% CI, 2.12-3.88; P<.001), 2.25 times the risk for experiencing a hospitalization for HS (95% CI, 1.42-3.56; P<.001), and 1.61 times the risk for experiencing a surgical encounter for HS (95% CI, 1.34-1.95; P<.001).

“Several factors are proposed to contribute to this difference, including higher rates of obesity and metabolic syndrome in African Americans, lower socioeconomic status, and possibly an anatomic predisposition of the apocrine glands,” said the study authors. “Despite this established disparity, there are insufficient data adequately assessing HS severity and outcomes across different racial and ethnic groups while controlling for potentially confounding factors,” the authors added.

In addition, the researchers found that females showed a significantly lower relative risk for all investigated end points than males. Similarly, current and past tobacco users exhibited higher relative risk than those who have never used tobacco.

“Although our study supports racial disparities in HS, it does not attempt to disentangle the possible contributing causes. Effectively defining and distinguishing these causes is crucial and will require further targeted research,” the authors concluded.

SOURCEAJMC