Prevalence of Hidradenitis Suppurativa Among Patients with Down Syndrome: a population based cross sectional analysis

Summary

Background

Hidradenitis Suppurativa (HS) has been linked to Down syndrome (DS).

Objective

To determine whether Down syndrome patients have a higher prevalence of HS, and whether diagnosis of HS occurs at an earlier age.

Methods

Cross-sectional analysis in a population sample of 11,936 DS patients and 16,813,290 non-DS patients. The primary outcome was diagnosis of HS. SNOMED-CT terms were used to identify patients with DS and HS. We used logistic regression models and significant interaction terms to evaluate the relationship between DS and HS. We also compared proportion of incident HS cases within five-year age groups to determine whether DS patients had earlier diagnosis of HS.

Results

Prevalence of HS among DS patients was 2.1%, compared to 0.3% for patients without DS (p<0.001). HS prevalence was greatest among DS patients who were aged 18-29 years. HS prevalence was not different between female and male DS patients or between white and non-white DS patients, after controlling for age, gender and obesity. Compared to those without DS, patients with the condition had increased odds of HS in unadjusted [OR 7.84, 95% CI 6.93-8.88] and adjusted [OR 5.24, 95% CI 4.62-5.94] analyses. Diagnosis of HS was made by the age of 29 years in 81.8% of patients with DS, compared to 34.0% of patients without the condition (p<0.001).

Conclusion

HS is strongly associated with DS across demographic subgroups, and the disease may present earlier life in these patients. These findings have implications for surveillance and care of patients with DS.

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