Many patients with hidradenitis suppurativa (HS) with an index emergency department visit for HS return to the emergency department, while few have follow-up dermatology visits, according to a study published online Oct. 26 in JAMA Dermatology .

Cynthia X. Wang, M.D., from the Washington University School of Medicine in St. Louis, and colleagues conducted a retrospective cohort study involving 20,269 patients with HS to examine interventions and patient factors associated with emergency department return following an initial emergency department visit.

Of the patients, 48.0 percent had incision and drainage performed at the index emergency department visit; 72.6 and 48.9 percent received an oral antibiotic prescription and an opioid medication prescription, respectively. The researchers found that 17.2 percent of patients had at least one return emergency department visit within 30 days for HS or proxy compared with 2.4 percent who had a dermatology visit. Within 180 days, 34.0 percent of patients had a return emergency department visit for HS or proxy, while 6.8 percent had a dermatology visit. The likelihood of returning to the emergency department for treatment was increased for patients with Medicaid and for those with an opioid prescription (odds ratios, 1.48 and 1.48, respectively, within 180 days); in contrast, these patients were less likely to have dermatology follow-up (odds ratios, 0.16 and 0.81, respectively, within 180 days).

"This study highlights a critical gap in care for patients with HS because a majority of these patients who present to the emergency department do not make it into the ambulatory dermatology setting for follow-up," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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