16604 A retrospective review of delay in diagnosis, severity of disease, and dermatology visits characterized by race in patients with hidradenitis suppurativa in a Midwestern population

Hidradenitis suppurativa (HS) is an inflammatory skin condition that disproportionately affects African Americans. We searched the Medical College of Wisconsin and Froedtert Health i2b2 electronic data warehouse, including more than 1.3 million patients in Southeast Wisconsin, for patients with an HS diagnosis and ≥3 encounters for HS using ICD9 705.83 and ICD10 L73.2 codes. We randomly characterized 373 of 1190 identified patients by retrospective chart review, excluding patients without an encounter for HS treatment. 51.1% (190) of patients were Black or African American (B/AA), 47.0% (175) were White or Caucasian (W/C), 1.9% (7) were other, and 1 patient lacked data. Age at initial presentation was documented in 271 B/AA or W/C patients with a mean age of 27.49 (n = 146) for B/AA and 31.03 (n = 125) for W/C patients. Of 249 patients with documentation of both year of symptom onset and year of diagnosis, the mean delay in diagnosis was 4.34 years (n = 132) for B/AA and 3.18 years (n = 117) for W/C patients. 135 B/AA or W/C patients had documentation of disease severity/stage. 29.5% (23) of B/AA patients had Hurley I as the worst documented stage, 25.6% (20) Hurley II, and 44.9% (35) Hurley III. 43.9% (25) of W/C patients had Hurley I as the worst documented stage, 28.1% (16) Hurley II, and 28.1% (16) Hurley III. 44.2% (84/190) of B/AA patients had seen dermatology for HS, compared with 60.0% (105/175) of W/C patients. Our data suggest B/AA and W/C populations may differ in HS characteristics for reasons that must be further explored.