Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.
602349371 Università Cattolica del Sacro Cuore, Dermatologia, Rome, Italy.
J Cutan Med Surg. 2022 Mar-Apr;26(2):127-134. doi: 10.1177/12034754211039993. Epub 2021 Oct 6.
Hidradenitis suppurativa is uncommon in patients of pediatric age, and differentiation with adult-onset disease is controversial. Treatment of pediatric hidradenitis suppurativa is scarcely standardized, and specific guidelines are lacking.
We report the clinical features, relevant risk-factors, comorbidity profile, and treatment patterns of a hospital-based cohort of pediatric hidradenitis suppurativa.
In a cross-sectional study data on patients' demographics, disease-specific characteristics, early/pre-pubertal onset of disease, comorbidities, and treatment management were retrieved. Reference population data and clinical data from the national hidradenitis suppurativa disease registry were used for comparison.
From a database of 870 patients with hidradenitis, 71 (15 males and 56 females) patients aged <18 years (mean age: 15.3 years; range 8-17 years), with mild (Hurley I, 45.1%) and moderate-severe disease (Hurley II-III, 54.9%), were retrieved. Smoking (23.9%) and overweight/obese frequencies (59.2%) were higher than reference population standards. Patient's older age at baseline (OR 1.43, 95% CI: 1.01 to 2.02) and higher BMI (OR 1.26, 95% CI: 1.07-1.48) were the only factors associated with moderate-severe disease. Family history and early/pre-pubertal onset of disease were not associated with severity or extent of disease. Sebaceous-follicular comorbid conditions were associated with cigarette smoking ( = .002). Among 81 treatment courses, clindamycin-based and zinc-sulphate-based combination regimens were most frequently used (59.3%). Female preponderance, family history of disease and extensive involvement were significantly different from the general hidradenitis suppurativa population.
Pediatric hidradenitis suppurativa presents a clinical spectrum comparable to adult-onset disease. Increased preventive measures should target obesity and smoking in this population.
化脓性汗腺炎在儿科患者中较为少见，且与成人发病的区别存在争议。儿科化脓性汗腺炎的治疗尚未标准化，且缺乏具体的指南。
我们报告了一个基于医院的儿童化脓性汗腺炎队列的临床特征、相关风险因素、合并症谱和治疗模式。
在一项横断面研究中，我们检索了患者的人口统计学、疾病特异性特征、疾病早发/青春期前发病、合并症和治疗管理的数据。我们使用了参考人群数据和国家化脓性汗腺炎疾病登记处的临床数据进行比较。
从一个 870 例化脓性汗腺炎患者的数据库中，我们检索到 71 例年龄<18 岁的患者（平均年龄：15.3 岁；范围 8-17 岁），其中轻度（Hurley I，45.1%）和中重度疾病（Hurley II-III，54.9%）。吸烟（23.9%）和超重/肥胖的频率（59.2%）高于参考人群标准。患者的基线年龄较大（OR 1.43，95%CI：1.01 至 2.02）和较高的 BMI（OR 1.26，95%CI：1.07 至 1.48）是与中重度疾病相关的唯一因素。家族史和疾病早发/青春期前发病与疾病的严重程度或范围无关。皮脂滤泡合并症与吸烟有关（ =.002）。在 81 个治疗疗程中，克林霉素和硫酸锌联合治疗方案最常用（59.3%）。女性患病率、疾病家族史和广泛受累与一般化脓性汗腺炎人群显著不同。
儿童化脓性汗腺炎表现出与成人发病相似的临床谱。在该人群中，应更加强针对性地采取预防措施来控制肥胖和吸烟。
