Research Finds Higher Rates of Precocious Puberty in Children with Hidradenitis Suppurativa

Hidradenitis suppurativa, a chronic inflammatory skin disorder characterized by painful nodules and abscesses, primarily affects areas of the body where skin rubs together, such as the armpits and groin. The condition is particularly challenging for younger patients, as it can impact both physical health and emotional well-being.

Sex hormones play a significant role in the onset and activity of hidradenitis suppurativa. Exploring the connections between HS and disorders related to sex hormones could enhance the understanding of HS pathophysiology and inform treatment strategies. Prior research has established associations between HS and androgen-related disorders, such as polycystic ovarian syndrome and acne.

Based on the evidence, Nicole Mastacouris, Northwell, New Hyde Park, New York, and colleagues hypothesized that precocious puberty—which involves increased androgen production and the early development of secondary sexual characteristics—may be linked to HS.

For this purpose, the researchers conducted a case-control study utilizing data from the Explorys database, which includes over 40 healthcare networks across the United States. They assessed 1,605 patients with hidradenitis suppurativa (HS), aged 15 to 18 years (median age 17 years, with 81.9% being women), alongside 180,933 individuals without HS, aged 10 to 16 years (median age 13 years, with 49.5% being women), during the period from March 2017 to February 2020. All patients had at least one healthcare encounter and a minimum of 12 months of observable person-time. The primary outcome of interest was the diagnosis of precocious puberty.

The following were the key findings of the study:

• In total, 40 patients with HS (2.5%) and 2120 participants without HS (1.2%) were diagnosed with precocious puberty.
• Precocious puberty was associated with more than a twofold higher risk for HS (odds ratio [OR], 2.16).
• The risk remained significant after adjusting for cofactors, such as demographic factors and body mass index (OR, 2.13).

The study's results align with those of a smaller European study and "provide further evidence supporting the involvement of sex hormones in the pathophysiology of HS," the authors noted. They emphasized the need for additional investigation into the role of sex hormones and their dysregulation in the development of HS.

Reference:

Mastacouris N, Midgette B, Strunk A, Garg A. Precocious Puberty Among Children and Adolescents With Hidradenitis Suppurativa. JAMA Dermatol. Published online September 18, 2024. doi:10.1001/jamadermatol.2024.3104