Background: Hidradenitis suppurativa (HS) is a long-term, inflammatory, recurring, and debilitating disorder. It usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, such as the axillae, inguinal folds, and perianal area. HS in pediatric patients has been understudied.The aims of this study were to describe the demographics, clinical features, treatment, and associated comorbidities in a cohort of pediatric patients with HS.Method: Retrospective-descriptive study of pediatric patients followed in a dermatology appointment between 2021 and 2024 with a diagnosis of HS. Demographics, clinical findings, time until diagnosis, family history, comorbidities, and treatment were collected.Results: A total of 55 patients with HS were followed in the last 4 years, 78.2% (43) female, with a mean age at disease onset of 12.69 years and a mean age at diagnosis of 14.36 years. Family history was present in 15 (27.3%) patients. Most patients were referred by primary care physicians (54.5%) or pediatricians (23.6%). The most affected sites were the inguinal area (76.4%), axilla (52.7%), inframammary (10.9%), vulva (10.9%), suprapubic (9.1%), gluteal (9.1%), and perianal (7.3%). 65.5% had more than one region affected. Regarding disease severity, 61.8% were Hurley stage 2, 23.6% stage 1, and 14.5% stage 3.Almost all (83.6%) patients had comorbidities, the most common were obesity (65.5%), acne vulgaris (32.7%), pilonidal sinus (18.2%), Crohn disease, and spondyloarthropathy (1.8% each). The most common treatment were antibiotics (98.2%-topical, 61.8%-systemic), hormone therapy (29.1%), finasteride (16.1%), and surgery (12.7%). Immune modulators were used in 18.2%, initially adalimumab, and in 2 refractory cases, secukinumab and upadacitinib. Most patients (74.5%) noticed improvements after starting treatment.Conclusion:There is a gap between first symptoms and diagnosis. Most pediatric patients with HS present with other comorbidities. It is important for physicians to recognize early signs in order to start timely treatment and avoid complications.
