HS patients with skin of color more likely to receive surgery than white patients

Hidradenitis suppurativa patients with skin of color are more likely to have surgical intervention than white patients, according to a poster presented at the Skin of Color Update virtual meeting.

This difference in treatment strategy may be due to delayed diagnosis and worse scarring.

“Hidradenitis suppurativa (HS) is a chronic disease that causes inflammatory lesions typically found in the axillary, inguinal and perineal regions that can result in permanent scarring, fibrosis and sinus tract formation,” India S. Robinson, BA, of the department of dermatology and dermatologic surgery at the Medical University of South Carolina, and colleagues wrote. “Although HS is more prevalent in patients with skin of color, research in HS has historically been performed in European and white populations.”

Researchers conducted a cross-sectional retrospective study of HS-associated visits and procedures at one South Carolina site and performed descriptive statistics and chi-square analyses.

Patients with skin of color had more visits and procedures than white patients. White patients were significantly more likely to be prescribed mood disorder agents (P = .033) and thyroid replacement hormones (P = .028), while patients with skin of color were more likely to be prescribed metformin (P = .024) and nonsteroidal anti-inflammatory drugs (P = .02). Complex excision was done in 11.6% of skin of color patients, compared with 5.5% of white patients. Triamcinolone injections were given to 68.5% of white patients compared with 60.9% of skin of color patients (P < .001).

Reasons for more surgical treatments could be due to a delay in diagnosis or be related to racial bias or socioeconomic status, but more studies are needed.

“Future studies should include a representative population of HS patients with a higher proportion of skin of color HS patients, perform racial subgroup analyses in clinical trials, include race as a variable when investigating medical and surgical outcomes and attempt to understand the different mechanisms that could explain differences in disease profiles across racial groups,” the authors wrote.