TOPLINE:

Children with hidradenitis suppurativa (HS) often received antibiotics for about a year before treatment escalation occurred, a study found.

METHODOLOGY:

• Researchers used the US TriNetX network database to study 6659 children with HS (mean age, 12.8 years at diagnosis; 74.9% girls; 37.7% White, 44.9% non-White; 56.5% non-Hispanic/Latino) from January 2005 to September 2025.
• Treatments prescribed within 1 year of diagnosis were categorized as systemic antibiotics, topical therapies, systemic hormonal therapies, retinoids, biologics, minor procedures, or major procedures.
• Time to treatment, first prescribed therapy, and time to switching were analyzed across sex, race, and ethnicity.
• Propensity score matching (1:1) was performed on comorbid conditions, age, and demographic variables, and treatment comparisons were reported as risk ratios (RR).

TAKEAWAY:

• The mean time to initial HS treatment was 14.8 days; non-White children initiated treatment approximately 16 days earlier than White children (1.0 vs 16.8 days, P < .0001).
• A combination of systemic antibiotics and topical therapies was most commonly prescribed (56.7%); topicals were most frequent in non‑Hispanic/Latino children (n = 1159; 39.9%) compared with the combination regimen in Hispanic/Latino children (n = 635; 61.0%).
• Mean duration on the initial treatment before switching was 385.7 days. Switching occurred sooner for White vs non-White children (424.7 vs 467.0 days; P = .0013) and for non‑Hispanic/Latino vs Hispanic/Latino children (405.0 vs 493.0 days; P < .0001).
• Girls were more likely than boys to receive systemic antibiotics (RR, 1.63; 95% CI, 1.44-1.85), topical therapies (RR, 1.70; 95% CI, 1.57-1.85), biologics (RR, 1.57; 95% CI, 1.15-1.96), and other therapies.

IN PRACTICE:

In this study, treatment patterns were characterized by prolonged time to treatment escalation, frequent use of antibiotic-based initial therapy, and variation in the timing of treatment initiation across demographic groups, the authors wrote. These findings suggest opportunities to improve early disease recognition, reassessment, and timely modification of therapy in pediatric HS, they added, noting that greater clarity around treatment escalation, regular follow-up during the initial treatment phase, and improved access to pediatric dermatology care may help reduce delays in effective management.

SOURCE:

The study was led by Shaliz Aflatooni, USF Health Morsani College of Medicine, Tampa, Florida, and was published online on April 14 in Pediatric Dermatology.

LIMITATIONS:

The database used in this study did not capture HS severity. Additionally, insurance status and distinction between care settings (pediatric dermatology vs general dermatology) were not available.

DISCLOSURES:

The authors did not disclose any funding information. One author disclosed serving as a research investigator, scientific advisor, and speaker for AbbVie, Alumis, Bristol Myers Squibb, Galderma, Johnson & Johnson, Leo, Lilly, Novartis, Pfizer, Regeneron, Sanofi, Sun, Takeda, and UCB. The other authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.