Pediatric patients with hidradenitis suppurativa (HS) are likely to see pediatricians and dermatologists before diagnosis and often receive diagnoses of folliculitis and comedones, according to a study published online Aug. 11 in JAMA Dermatology.

Katherine K. Hallock, M.D., from Penn State University in Hershey, and colleagues conducted a retrospective cohort study that included adult and pediatric patients with HS claims during Jan. 1, 2012, to Dec. 31, 2016. Health care utilization patterns were compared for pediatric and adult patients.

Data were included for 8,727 patients, including 1,094 pediatric patients and 7,633 adult patients. The researchers found that before diagnosis, pediatric patients were likely to see pediatricians, dermatologists, emergency department staff, and family physicians, and they often received diagnoses of folliculitis and comedones. High rates of comorbid skin and general medical conditions were seen in pediatric patients with HS, including acne vulgaris, acne conglobata, obesity, and anxiety disorders (51.0, 45.9, 33.7, and 33.6 percent, respectively). Compared with adult patients, a higher percentage of pediatric patients had HS-specific claims for services rendered by emergency and urgent care physicians (35.6 versus 28.2 percent and 18.1 versus 13.4 percent, respectively); however, inpatient stays were more likely among adult patients (2.38 versus 4.22 percent). Pediatric and adult patients had 2.24 and 3.5 emergency department claims per person, respectively; the mean cost per claim was similar for emergency department claims.

"Pediatric patients utilize high-cost emergency department care when HS in children and adults can often be treated as an outpatient if referred to the proper specialist," the authors write. "These data suggest that there are opportunities to improve recognition of HS in pediatrics by nondermatologists and dermatologists."

One author disclosed financial ties to the pharmaceutical industry.

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