Current HS Diagnostic Criteria May Not Adequately Cover Disease in Pediatric Patients

A recent study indicates that many pediatric patients with hidradenitis suppurativa (HS) do not meet all major diagnostic criteria at the time of diagnosis, indicating that existing HS criteria may not adequately capture disease in this young population. The findings were reported in JAMA Dermatology.

Investigators of this study sought to discern the proportion of physician-diagnosed pediatric patients with HS who met diagnostic criteria, and to delineate  demographics, disease characteristics, and diagnostic patterns in this patient population.

This was a retrospective, cross-sectional study by design in which researchers analyzed electronic medical records from 297 adolescents with HS (78.1% female, 26.3% Black, 39.1% Hispanic) from two sites of a single academic tertiary care center. The population of interest were required to be born after January 1, 1993, and assigned International Classification of Diseases, Ninth and Tenth Revisions (ICD-9/10) codes for HS (ICD-9 705.83/ICD-10 L73.2) between January 1, 2012, and July 1, 2021. Any patients older than 18 years at diagnosis, had inaccessible diagnostic visit notes, or were unintentionally assigned an HS ICD code were excluded from analysis. The primary outcome was defined as fulfillment of diagnostic criteria in pediatric patients with HS.

The results found that the average age at diagnosis was 14 years. The researchers observed that 42.8% patients did not meet all 3 major HS diagnostic criteria. Of these patients, the researchers noted that the vast majority (96.1%) did not meet the recurrence interval criterion (≥2 lesions within 6 months).

The researchers concluded that “pediatric patients with HS in this retrospective cross-sectional study did not meet all major diagnostic criteria at the time of diagnosis, largely due to failure to fulfill the 6-month recurrence interval criterion.”

“Future studies are needed to determine the appropriate recurrence interval to facilitate timely diagnosis and promote clinical trial eligibility for pediatric patients with HS,” they added.