Pediatric Research
Pediatric Endoscopic Hidradenitis Treatment:
A New Minimally Invasive Treatment for Pediatric Patients with HS
​
Note: Pediatric HS is not 'infrequent,' just incredibly misdiagnosed and under-reported.
Synopsis:
​
Background: Hidradenitis suppurativa (HS) is infrequent in the pediatric population. When indicated, surgery is often invasive, painful, and with significant recurrence rate. We aimed to report our preliminary experience using a new endoscopic technique to treat this pathology. Materials and Methods: We reported the data of 11 patients (9 girls and 2 boys) with average age of 15.7 years (range 14-17) with HS, who were operated using endoscopic procedure for a 15-month period. Six patients presented axillary, inguinal, and inframammary localizations, 3 patients presented axillary and inguinal localizations, and 2 patients presented only inguinal localization. Pediatric endoscopic hidradenitis treatment (PEHT) followed the same principles of pediatric endoscopic pilonidal sinus treatment (PEPSiT). The fistuloscope was introduced into the different holes, and after using an endobrush, all tracts were cauterized using monopolar electrode or laser energy, and finally the granulation tissues were removed using graspers. At the end of the procedure, all the holes were filled with oxygen-enriched oil-based gel and covered with fat gauze. Results: The average operative time was 47 minutes (range 30-80). All procedures were performed in a day surgery setting or with an overnight hospitalization. All patients reported no pain postoperatively and performed a local dressing with silver sulfadiazine spray and oxygen-enriched oil-based gel two times per day for 1 month postoperatively. At the longest follow-up of 1 year, the lesions were completely healed in all cases. Two patients (18%) developed further lesions in different untreated localizations that were successfully treated using PEHT. Conclusions: PEHT is a minimally invasive, effective, and safe treatment option for pediatric patients with HS. All patients reported a painless postoperative period and excellent results. Postoperative local dressings using oxygen-enriched oil-based gel and silver sulfadiazine spray are fundamental to achieve the complete healing. However, a further evidence with larger series and longer follow-up is required to confirm these preliminary results.
​
Full Research Link:
​
https://www.ncbi.nlm.nih.gov/m/pubmed/32017645/?i=2&from=hidradenitis
Differences Between Children and Adults With Hidradenitis Suppurativa
​
Research Synopsis:
​
This cohort study suggests that pediatric patients utilize high-cost ED care when HS can often be treated as an outpatient. These data suggest that there are opportunities to improve recognition of HS in pediatric patients by non-dermatologists and dermatologists.
Research circulation links below:
​
https://pubmed.ncbi.nlm.nih.gov/34379074/
https://jamanetwork.com/journals/jamadermatology/article-abstract/2782885
Recognizing the Effects & Disparities of Pediatric HS
Research Synopsis:
​
In 2015, hidradenitis suppurativa (HS) was deemed a rare disease that was reported to affect fewer than 200 000 adults in the US, thus allowing adalimumab (Humira; AbbVie) to gain orphan drug approval for the treatment of moderate to severe disease in adults.1 Three years later in 2018, adalimumab was granted orphan drug approval for moderate to severe HS in adolescents (age 12-17 years), a group thought to be even less frequently affected by HS compared with adults.1 However, in the same year, Ingram et al2 reported updated epidemiological data on the prevalence of HS, with an estimated overall prevalence of HS at 0.77% in a Western population. The data by Ingram et al2 confirmed the experience of many dermatologists, that HS is not uncommon, but rather unseen.
​
Research circulation links below:
​
