Ethnicity and hidradenitis suppurativa

J Invest Dermatol. 2014 Nov;134(11):2842-3. doi: 10.1038/jid.2014.220. Epub 2014 May 12.

Ethnicity and hidradenitis suppurativa.

There is a lack of definitive epidemiologic information on patients who suffer from hidradenitis suppurativa (HS), as well as poor understanding of the etiology of this process. It is essential to gather more accurate information regarding HS as understanding of disease associations may lead to improved comprehension of the pathology. In their recent report, Vazques et al. (2013)) have put forth an excellent population-based study on this disease process, which helps to provide valuable information on such associations. They found that 90.3% of the patients with HS in Olmsted County, Minnesota, were white, but specifically note that this racial breakdown may be a reflection of the racial demographics of the county itself, which is predominantly white. The classical teaching regarding HS has been that this process occurs more frequently in those of African descent (McMichael et al., 2008). However, many of the published epidemiologic studies are similar to this publication in reporting a predominance of whites among those affected. It is important to consider that many of these studies are drawn from the northern or western European populations. This may again be a reflection of the demographics of these regions, but this message dominates the available literature.
Over the last several years, we have increasingly recognized that there is a large population of patients in our area who suffer from follicular disorders, particularly HS. As such, we have performed our own retrospective review of all HS patients seen in our clinic during an 18-month time period from 1 January 2011 to 31 May 2012.

All encounters were searched, and there were 366 patients identified with the clinical diagnosis of HS seen in the Dermatology Clinic at the Henry Ford Medical Center during this time period. Given that overall there were 8,480 patients seen in the clinic during this time, HS patients comprised 4.3% of the dermatology clinic patient population. For 6,664 of these patients, including all 366 of the patients with the diagnosis of HS, there were data available regarding race. In addition, the US Census Bureau data for Wayne County, Michigan, in 2010 (http://quickfacts.census.gov/qfd/states/26/26163lk.html, accessed 21 May 2013) indicate that the population of Wayne County was 54.2% white and 41.8% black. For the HS patients, 54.4% (199) were black, 25.7% (94) were white, and the remaining 19.9% (73) were classified as “other.” Looking at the overall population of patients seen in the Henry Ford Dermatology Clinic for all diagnoses, 47.0% (3,131) were black, 35.8% (2,389) were white, and 17.2% (1,144) fell into the category of “other.” We found that 6.4% of the black patients as compared with 3.9% of the white patients seen in the clinic were seen for the diagnosis of HS (P-value of<0.001), using a chi-square test, SAS9.2 (SAS, Cary, NC) (Table 1). We feel our data support the traditional teaching that HS is more common in those of African descent, which is not currently substantiated in the medical literature.

Table 1: Ethnicity of HS patients versus non-HS patients for the Henry Ford Dermatology Clinic
WhiteBlackOtherP-value
All non-HS patients2,295 (96.1%)2,932 (93.6%)1,071 (93.6%)<0.001
HS patients94 (3.9%)199 (6.4%)73 (6.4%)
  1. McMichael, A., Guzman-Sanchez, D., and Kelly, P. Folliculitis and other follicular disorders. in: J.L. Bolognia, J.L. Jorizzo, R.P. Rapini (Eds.) Dermatology. Mosby Elsevier, Spain; 2008: 528
  2. Vazquez, B.G., Alikhan, A., Weaver, A.L. et al. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol. 2013; 133: 97–103

FULL TEXT SOURCE: jidonline.org

PMID: 24820891
DOI: 10.1038/jid.2014.220

Source: Ethnicity and hidradenitis suppurativa. – PubMed – NCBI

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