483 Hidradenitis suppurativa in a cohort of sixty years and older

Abstract

Hidradenitis suppurativa (HS) is a chronic, recurrent skin disorder characterized by painful nodules, pustules, purulent abscesses, and sinus tracts (“tunnels”) leading to progressive disability. While the epidemiology of HS has been reported, this has not been explored in patients 60 years and older. Our study examines this cohort. We identified 51 patients aged 60 and older with HS who were seen Montefiore Medical Center between 2015 and 2019. There were 39 females (76.5%); 26 (50.9%) self-identified as black or African-American, 7 (13.7%) as white, 11 (21.6%) as other, and 7 (13.7%) declined to respond or were unsure. Ethnic analysis revealed 7 (13.7%) were Spanish/Latino/Hispanic, and 33 (64.7%) were non-Spanish/Latino/Hispanic , while 11 (21.6%) declined to respond or did not know. Body mass index (BMI) was available for 37 patients: 7(18.9%) were normal BMI, 6 (16.2%) were overweight, 12 (32.4% ) were obese, and 12 (32.4%) were very obese. Of 49 patients who reported smoking history: 16 (32.6%) were current smokers, 18 (36.7%) were former smokers, 15 (30.6%) were never smokers. Forty-one patients reported information about temporal landmarks: the average age of symptom onset was 45.3 years (±19.7) and the average age at diagnosis was 65.2 (±5.0). Family history was documented for 32 patients: 17 (53.1%) reported a family history of HS and 15 (46.9% ) did not. HS Physician Global Assessment (HS-PGA) and Hurley Scores were recorded at the initial visit for 26 patients and 37 patients, respectively. The average HS-PGA was 2.5 (±1.1), while the average Hurley stage was 2.1 (±0.92). Hidradenitis suppurativa occurs frequently among patients aged 60 and older. Our findings suggest there may be tertiary peak later in life. It appears that smoking status, BMI, and family history parallel the findings in the general HS population; however these findings indicate a need for further investigation of this cohort. Naik HB, Paul M, Cohen SR, Alavi A, Suàrez-Farñas M, Lowes MA. Distribution of self-reported hidradenitis suppurativa age at onset. JAMA Dermatol. 2019.