Hospitalized hidradenitis suppurativa patients at a university clinic: a fifteen-year retrospective analysis of hospitalized patients with a focus on sex differences

Hidradenitis suppurativa (HS) is a chronic skin disease marked by recurrent abscesses, sinus tracts, and scarring, often accompanied by systemic symptoms. Diagnosed clinically, HS affects around 0.4% of people in western populations, but standardized treatment options are limited, leading to inconsistent outcomes. This study retrospectively analyzes 15 years of HS cases in southeastern Europe to better understand regional characteristics and treatment responses. This is a retrospective, cross-sectional study encompassing 103 HS patients hospitalized from 2007 to 2022 at a university dermatology and venereology clinic. Women were younger than men at onset of HS (19 vs. 28 years old) and at first hospitalization (31 vs. 39 years old). Men were most often diagnosed as Hurley stage III at hospital admission (50.8%), whereas women predominantly had Hurley stage II (57.5%, p = 0.032). Trunk involvement was more prevalent in women (62.5% vs. 41.3%, p = 0.036) and the back of the neck in men (30.2% vs. 7.5%, p = 0.006). Obesity was the most commonly found concurrent disease (35.9%) overall, and a history of acne was the most frequent dermatological comorbidity (29.1%). HS patients had a fivefold increase in their chance of having psoriasis. The most commonly employed systemic treatments were oral antibiotics: rifampicin with clindamycin (62.1%) followed by tetracyclines (42.7%). HS patients had a fivefold higher likelihood of having psoriasis. Female patients were less likely to experience severe disease presentations. Although metabolic syndrome and its components were relatively common, they showed no correlation with disease severity. Treatment approaches for HS varied notably between males and females.