Children and adolescents with hidradenitis suppurativa (HS) have a considerable risk for developing somatic and psychiatric comorbidities, with the prevalence of mental disorders increasing at a rapid rate during young adulthood, according to the results of a retrospective matched case-control database study published in the Journal of the American Academy of Dermatology.

All patients who were diagnosed with HS between 1987 and 2014 as part of the Finnish Care Registry of Health Care were recruited. The investigators collected data from patients with HS between age ≥5 and <18 and from age-matched controls with benign melanocytic nevi. The prevalence of preselected comorbidities was compared in the HS and control arms.

A total of 153 patients with HS within the specified age-group were identified. Of these individuals, 34.0% exhibited ≥1 comorbidity, compared with 4.9% of control participants. Of the preselected psychiatric diagnoses, ≥1 was reported before age 18 in 15.7% of patients with HS vs 5.6% of controls. Moreover, at age 23, ≥1 psychiatric comorbidity was recognized in 23.5% of participants with HS vs 8.7% of controls.

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Among the somatic comorbidities evaluated were acne, type 1 diabetes, Down syndrome, hypertension, inflammatory bowel diseases, inflammatory joint diseases, metabolic syndrome, obesity, pilonidal sinus, and thyroid disorders. Psychiatric comorbidities included major depression and anxiety disorders, as well as anxiety, dissociative, stress-related, somatoform, and other nonpsychotic mental disorders.

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Although this was one of the largest HS cohorts ever evaluated, the number of young patients with HS was relatively low. As this was a registry-based analysis, it was not possible to confirm the accuracy of the International Classification of Disease codes.

The investigators concluded that physicians should monitor young patients with HS for both psychiatric and somatic comorbid disorders, as they may require substantial care both for their HS lesions and for the comorbidities associated with their disorder, which may accumulate over time.


Tiri H, Jokelainen J, Timonen M, Tasanen K, Huilaja L. Somatic and psychiatric comorbidities of hidradenitis suppurativa in children and adolescents. [published online March 5, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.02.067