JAMA Dermatology

<jats:sec id="ab-doi250021-4"><jats:title>Importance</jats:title><jats:p>Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease characterized by painful nodules in intertriginous regions that affects many pediatric patients. A significant proportion of patients with pediatric-onset HS may experience comorbidities, including metabolic and psychiatric disorders, adversely impacting their quality of life.</jats:p></jats:sec><jats:sec id="ab-doi250021-5"><jats:title>Objective</jats:title><jats:p>To evaluate the association between HS and relevant comorbidities in pediatric patients and determine the overall pooled prevalence of comorbidities in pediatric patients with HS.</jats:p></jats:sec><jats:sec id="ab-doi250021-6"><jats:title>Data Sources</jats:title><jats:p>Embase, PubMed/MEDLINE, and the Cochrane Central Register were searched on February 20, 2025, from database inception with no restrictions.</jats:p></jats:sec><jats:sec id="ab-doi250021-7"><jats:title>Study Selection</jats:title><jats:p>Original investigations that reported on prevalence or association between pediatric HS and comorbidities were included. The search included key search terms for pediatric HS and different categories of comorbidities. Two independent authors performed screening and full-text review.</jats:p></jats:sec><jats:sec id="ab-doi250021-8"><jats:title>Data Extraction and Synthesis</jats:title><jats:p>Extraction was done by 2 authors independently using a template. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. Data were pooled using random-effects modeling.</jats:p></jats:sec><jats:sec id="ab-doi250021-9"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Meta-analyses of proportions were completed to estimate pooled prevalence rates, categorizing the data by specific comorbidities (obesity, overweight, anxiety, and others).</jats:p></jats:sec><jats:sec id="ab-doi250021-10"><jats:title>Results</jats:title><jats:p>A total of 19 studies, encompassing 17 267 pediatric patients with HS and 8 259 944 controls, were included. Pediatric patients with HS included in studies were predominantly female (mean of 76.7% [11 683 of 15 232]). The most prevalent comorbidities were acne vulgaris (pooled proportion, 43%; 95% CI, 21-65), obesity (pooled proportion, 37%; 95% CI, 27-46), anxiety (pooled proportion, 18%; 95% CI, 4-31), and hirsutism (pooled proportion, 14%; 95% CI, 6-21). Multiple studies reported on the concurrence of pediatric HS and obesity or depression (GRADE: moderate certainty), and 3 studies reported an association with diabetes (GRADE: low certainty).</jats:p></jats:sec><jats:sec id="ab-doi250021-11"><jats:title>Conclusions and Relevance</jats:title><jats:p>In this study, pediatric patients with HS had increased prevalence of chronic medical and psychiatric comorbidities, highlighting the potential benefit of a multidisciplinary approach.</jats:p></jats:sec>

Dictionnaire de Médecine, ou Répertoire Général des Sciences Médicales considérées sous les Rapports, Theorique et Pratique.

Prov Med Surg J

Hidradenitis suppurativa in pediatric patients.

Pediatrics

Prevalence estimates for hidradenitis suppurativa among children and adolescents in the United States: a gender- and age-adjusted population analysis.

J Invest Dermatol

Obstacles to early diagnosis and treatment of hidradenitis suppurativa: current perspectives on improving clinical management.

Clin Cosmet Investig Dermatol

Evaluation of hidradenitis suppurativa diagnostic criteria in pediatric patients.

JAMA Dermatol

Association between obesity and hidradenitis suppurativa among children and adolescents: a population-based analysis in the United States.

J Am Acad Dermatol

The comorbidity burden of hidradenitis suppurativa in the United States: a claims data analysis.

Dermatol Ther (Heidelb)

Physical and psychosocial comorbidities of pediatric hidradenitis suppurativa: a retrospective analysis.

Pediatr Dermatol

Somatic and psychiatric comorbidities of hidradenitis suppurativa in children and adolescents.

Care for adolescents with polycystic ovary syndrome: development and prescribing patterns of a multidisciplinary clinic.

J Pediatr Adolesc Gynecol

Hidradenitis suppurativa in the pediatric population: an international, multicenter, retrospective, cross-sectional study of 481 pediatric patients.

Differences between children and adults with hidradenitis suppurativa.

PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews.

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.

Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline.

Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.

Eur J Epidemiol

GRADE system: classification of quality of evidence and strength of recommendation.

Cir Esp

New-onset anxiety in paediatric patients with hidradenitis suppurativa.

J Eur Acad Dermatol Venereol

A report of 1290 pediatric hidradenitis suppurativa hospitalizations: a nationwide analysis from the Kids’ Inpatient Database.

Pediatric hidradenitis suppurativa: a cross-sectional study on clinical features and treatment approaches.

J Cutan Med Surg

Disease burden and treatment patterns among US patients with hidradenitis suppurativa: a retrospective cohort study.

Am J Clin Dermatol

Prevalence of Crohn disease among pediatric patients with hidradenitis suppurativa.

Prevalence of polycystic ovarian syndrome among children and adolescents with hidradenitis suppurativa.

Precocious puberty among children and adolescents with hidradenitis suppurativa.

Baseline characteristics from UNITE: an observational, international, multicentre registry to evaluate hidradenitis suppurativa (Acne Inversa) in clinical practice.

Clinical characteristics of pediatric hidradenitis suppurativa: a cross-sectional multicenter study of 140 patients.

Arch Dermatol Res

Hidradenitis suppurativa in Black pediatric patients - a national analysis of the Kids’ Inpatient database.

Hidradenitis suppurativa and metabolic syndrome: a comparative cross-sectional study of 3207 patients.

Br J Dermatol

Hidradenitis suppurativa in paediatric patients: a retrospective monocentric study in Germany and review of the literature.

Prevalence of depression among children, adolescents, and adults with hidradenitis suppurativa.

New-onset depression among children, adolescents, and adults with hidradenitis suppurativa.

The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: systematic review and meta-analysis.

Hidradenitis suppurativa: the role of immune dysregulation.

Int J Dermatol

Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa.

Metabolic disorders/obesity is a primary risk factor in hidradenitis suppurativa: an immunohistochemical real-world approach.

Dermatology

The role of new inflammatory markers in determining disease activation and severity in patients with hidradenitis suppurativa.

Correlation of inflammatory serum markers with disease severity in patients with hidradenitis suppurativa (HS).

Weight loss and dietary interventions for hidradenitis suppurativa: a systematic review.

Hidradenitis suppurativa should be recognized as a weight-related comorbidity in National Institute for Health and Care guidelines on managing obesity.

Clin Exp Dermatol

The treatment of hidradenitis suppurativa with the glucagon-like peptide-1 agonist liraglutide.

Screening for diabetes mellitus in patients with hidradenitis suppurativa-a monocentric study in Germany.

Int J Mol Sci

Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity.

Youth mental health crisis management.

Nat Ment Health

Navigating the “mental health crisis” in adolescents in the aftermath of Covid-19 pandemic: experience and insights from frontline psychiatric service.

Clin Neuropsychiatry

Hidradenitis suppurativa and chromosomal abnormalities: a case report and systematic review of the literature.

The possible association of hidradenitis suppurativa and Down syndrome: is increased amyloid precursor protein expression resulting in impaired Notch signalling the missing link?

Hidradenitis suppurativa and Down syndrome: a systematic review and meta-analysis.

Hidradenitis suppurativa associated with Down syndrome is characterized by early age at diagnosis.

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease characterized by painful nodules in intertriginous regions that affects many pediatric patients. A significant proportion of patients with pediatric-onset HS may experience comorbidities, including metabolic and psychiatric disorders, adversely impacting their quality of life.
To evaluate the association between HS and relevant comorbidities in pediatric patients and determine the overall pooled prevalence of comorbidities in pediatric patients with HS.
Embase, PubMed/MEDLINE, and the Cochrane Central Register were searched on February 20, 2025, from database inception with no restrictions.
Original investigations that reported on prevalence or association between pediatric HS and comorbidities were included. The search included key search terms for pediatric HS and different categories of comorbidities. Two independent authors performed screening and full-text review.
Extraction was done by 2 authors independently using a template. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. Data were pooled using random-effects modeling.
Meta-analyses of proportions were completed to estimate pooled prevalence rates, categorizing the data by specific comorbidities (obesity, overweight, anxiety, and others).
A total of 19 studies, encompassing 17 267 pediatric patients with HS and 8 259 944 controls, were included. Pediatric patients with HS included in studies were predominantly female (mean of 76.7% [11 683 of 15 232]). The most prevalent comorbidities were acne vulgaris (pooled proportion, 43%; 95% CI, 21-65), obesity (pooled proportion, 37%; 95% CI, 27-46), anxiety (pooled proportion, 18%; 95% CI, 4-31), and hirsutism (pooled proportion, 14%; 95% CI, 6-21). Multiple studies reported on the concurrence of pediatric HS and obesity or depression (GRADE: moderate certainty), and 3 studies reported an association with diabetes (GRADE: low certainty).
In this study, pediatric patients with HS had increased prevalence of chronic medical and psychiatric comorbidities, highlighting the potential benefit of a multidisciplinary approach.

Prevalence of Comorbidities Among Pediatric Patients With Hidradenitis Suppurativa: A Meta-Analysis.

Prevalence of Comorbidities Among Pediatric Patients With Hidradenitis Suppurativa

Prevalence of Comorbidities Among Pediatric Patients With Hidradenitis Suppurativa

Clinical Summary

What was studied

Key findings

Study limitations

Clinical implications

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