Racial disparities in patients with hidradenitis suppurativa: effects on diagnosis and quality of life

Hidradenitis suppurativa (HS), a chronic autoinflammatory disease affecting the skin, poses significant challenges in diagnosis, treatment, and quality of life (QOL), with a disproportionate impact on different racial and ethnic groups. This review explores the epidemiology, risk factors, diagnostic delays, treatment modalities, and the varying quality of life experiences of patients with HS, focusing on the substantial disparities faced by Black individuals. Despite a worldwide prevalence of ∼1%, HS exhibits a higher occurrence in Black patients in the United States, leading to more severe disease states, delayed diagnoses, decreased QOL, and increased health care resource utilization. The article delves into the complexity of HS diagnosis, emphasizing the importance of early detection to prevent disease progression and the role of dermatology clinicians in accurate diagnosis compared with nondermatology settings. Treatment options, including antibiotics, biologics, and surgical interventions, are discussed with a focus on the need for diverse representation in clinical trials. The impact of HS on QOL is profound, affecting various aspects such as mental health, sexual well-being, and daily functioning. Notably, this review highlights the underrepresentation of people of color in HS research, contributing to a limited understanding of racial and ethnic influences on the disease. The article highlights the need to advocate for increased access to dermatologic care, community outreach, and further research involving diverse populations to address the existing disparities in HS diagnosis, treatment, and outcomes.