Progression From Cutaneous Abscess to Hidradenitis Suppurativa: A Retrospective Analysis.

Background: Hidradenitis suppurativa (HS) is often diagnosed late in disease course after irreversible scarring, and other modifiers of quality of life have occurred. Identifying HS earlier may help reduce long-term impact.

Objective: This study examines how often patients diagnosed with cutaneous abscesses are later identified as having HS, time to HS diagnosis, and demographic factors associated with diagnosis.

Methods: The study was conducted at Atrium Health Wake Forest Baptist from 2012 to 2023. Data on demographics, clinical history, abscess and lesion locations, HS diagnosis, and time to HS diagnosis were collected. Chi-squared and t-tests were conducted to compare outcomes.

Results: Four hundred seventy-one patients, predominantly women [70.1%], met inclusion criteria. Seventy-one patients were diagnosed with HS, predominantly women [80.3%]. HS patients were more likely (35.6%) to have abscesses in the axillae (χ2 = 28.3, p < .0001), inframammary region (χ2 = 18.7, p < .0001), or inguinal folds (χ2 = 12.2, p = .005) than those with boils in nontypical locations (5.4%) (χ2 = 66.8, p < .0001).

Conclusion: The heterogeneous nature of HS makes early definitive diagnosis challenging. The anatomic location of abscesses may help identify patients for early intervention and treatment of this debilitating condition.