Severity of Hidradenitis Suppurativa Associated With Age of Symptom Onset

pain underarm armpit woman female doctor
Breast Cancer Prevention Concept. A woman suffers from pain in the armpit. Sweating, unpleasant odor, redness, tooth and inflammation in the armpit.
Researchers determined the factors associated with disease activity in patients with hidradenitis suppurativa.

The following article is a part of conference coverage from the 2022 American Academy of Dermatology Annual Meeting , held live from March 25 through March 29 in Boston, Massachusetts. The team at Dermatology Advisor will be reporting on the latest news and research conducted by leading experts in dermatology. Check back for more from the 2022 AAD Annual Meeting .


Later onset of hidradenitis suppurativa (HS) symptoms is associated with more severe disease, according to research presented at the 2022 American Academy of Dermatology (AAD) Annual Meeting, held from March 25 to 29, 2022, in Boston, Massachusetts.

Researchers aimed to study the effect of age at onset of HS symptoms on disease severity.

Individuals who visited the HS Clinic at the Duke University Medical Center from January 1, 2015, to December 31, 2020 and were aged 40 years at the time of the initial visit were eligible in the study.

Researchers used a multivariable regression model with covariates including age at symptom onset, sex, smoking, body mass index, race, insulin resistance, hormone modulatory therapy, oral antibiotics, and immunomodulatory therapy to assess the factors associated with disease severity.

Earlier-onset HS was defined as age 30 years and older and later-onset HS was defined as age younger than 30 years.

A total of 102 patients [MR1] (72 with earlier-onset HS and 39 with later-onset HS) were included in the final analysis.

Patients with later- vs earlier-onset HS had significantly increased median International HS scores (IHS4; 15.0 vs 5.0; unadjusted P =.007) and Modified Sartorius Scores (MSS; 64.0 vs 32.5; unadjusted P =.01).

In the subgroup analysis of women patients with HS (n=83), later- vs earlier-onset HS was significantly associated with a higher median IHS4 (15.0 vs 4.5; unadjusted P =.001) and MSS (79.0 vs 26.5; unadjusted P =.002).

“Our results demonstrate that later onset of HS symptoms is associated with more severe disease, and this relationship remains significant in [women],” the researchers noted. “Further analyses adjusting for variables that impact HS severity are needed to explore the basis for this potential difference.”

Disclosure: One study author declared affiliations with pharmaceutical companies. Please see the original reference for a full list of authors’ disclosures.


Jiang SW, Petty AJ, Jacobs JL, et al. Association between age of symptom onset and severity of hidradenitis suppurativa in older patients. Presented at: 2022 AAD Annual Meeting; March 25-29, 2022; Boston, MA. Poster #33498.

Visit Dermatology Advisor’s conference section for more coverage from AAD 2022.