Comparison of hidradenitis suppurativa (HS) management and risk factors in pediatric HS patients with and without psychiatric comorbidities

Summary: Abstract Body: This project aims to compare socioeconomic status and management of hidradenitis suppurativa (HS) between a pediatric HS cohort and a pediatric cohort with both HS and a psychiatric condition such as anxiety or depression. We conducted a retrospective chart review of 1015 patients diagnosed with HS before age 18 within the UPMC electronic medical record. The study included 576 pediatric patients who only had HS, and 439 patients who were diagnosed with HS and a psychiatric comorbidity such as anxiety, depression, or social phobia. There were no significant differences between these two groups in demographics or average age of HS diagnosis. Black patients in both the HS cohort and the HS + psych cohort were more likely than their white peers to be on public insurance instead of private insurance (OR=2.108, p=0.000269; OR=2.0657, p=0.00091). Children with both HS and a psychiatric comorbidity were significantly less likely to have private insurance (OR=0.2194, p<0.0001, 95%CI: 0.168-0.2825), and were significantly less likely to be diagnosed with HS by a dermatologist (OR=0.4982, p<0.0001, 95%CI=0.3816 to 0.6503) than their peers who had only HS. Finally, within the cohort of patients diagnosed with both HS and a psychiatric comorbidity, Black patients were significantly less likely than white patients to be diagnosed with HS by a dermatologist (OR=0.5043, p=0.0091, 95%CI=0.3016 to 0.8434). These findings suggest that pediatric HS patients who also have a psychiatric comorbidity are less likely to have access to care from dermatologists and adequate treatment resources, with black patients in this cohort being more affected. They highlight the need for greater access to both dermatological and mental health care. Sydney E. DeVore¹, Selina J. Chang¹, Jonathan Hwang¹, Aniket Dhariwal¹, Aliyyat Afolabi¹, Vincenzia Vargo¹, Ellen Koch¹ 1. Dermatology, University of Pittsburgh, Pittsburgh, PA, United States. Clinical Research: Epidemiology and Observational Research