Hidradenitis Suppurativa in a Pediatric Patient (Younger Than 18 Years)
Managing hidradenitis suppurativa (HS) in children and adolescents requires the same clinical rigour applied to adult disease, but with age-specific considerations that shape which interventions are appropriate. This protocol addresses the evaluation and first-line management of HS in patients younger than 18 years.
Clinical Scenario
The patient is a pediatric individual under 18 years of age presenting with hidradenitis suppurativa. Management strategies in this population are similar to those for adults, but certain therapies carry age-based restrictions that must be observed.
Treatment Approach (Partial Overview)
The approach incorporates lifestyle modification alongside topical and, where appropriate, systemic antimicrobial therapies — selected with attention to the patient's age. Some agents used in adult HS management are contraindicated or require dose adjustment in younger pediatric subgroups.
References
DOI: 10.1016/j.jaad.2019.02.067
- Management strategies are similar to those for adults with some specific considerations outlined in Table VIII.
- Topical clindamycin may reduce pustules in HS, but it carries a high risk of bacterial resistance.
- A prospective case series on the effect of intralesional triamcinolone, 10 mg/mL (0.2–2.0 mL), into inflamed HS lesions demonstrated significant reductions in physician-assessed erythema, edema, suppuration, and size.
- Tetracyclines are recommended in mild-to-moderate HS for a 12-week course or as long-term maintenance when appropriate.
- Avoid tetracyclines in children younger than 9 years and acitretin in female patients during the childbearing years.