The Impact of Food Desert Residence on Hidradenitis Suppurativa: Results from a Single Center Cohort Study (Preprint)

UNSTRUCTURED Hidradenitis suppurativa (HS) is a chronic and debilitating skin condition associated with several comorbidities, including diabetes mellitus, cardiovascular disease, and smoking. Despite these known associations, the relationship between HS and environmental factors remains poorly understood. Food deserts (FD), defined as limited access to nutritious food in low-income communities, is a possible contributing factor. In this study, we evaluated the impact of living in food deserts (FD) on the prevalence of patients with HS seen in our wound clinic. We conducted a retrospective review of patients diagnosed with HS who were seen at our institutional wound clinic from 2014 to 2024. Zip codes of patients were collected, and their residence in a FD was determined using the U.S. Department of Agriculture Adult Food Security Survey criteria. Demographic data, including socioeconomic variables, patient comorbidities, HS characteristics, and Hurley Stages were also collected. Among 191 patients with HS, the median age was 40 years old, with a median body mass index of 31.1 kg/m2, and 72.3% were female. Overall, 36.6% (n=70) of the patients resided in a FD. A significant difference in race (p=0.01) was observed between patients living in a FD and those who did not. Patients in a FD had significantly lower median household incomes ($71,964 vs. $101,434, p<0.001), and received fewer immunologic treatments for HS (14.3% vs. 27.3%, p=0.038). Other demographic variables including obesity class, diabetes, smoking, or insurance type were not significant between the two cohorts. Overall, 51.8% of patients experienced HS in multiple locations, which did not differ between FD and non-FD cohorts. There were no significant differences in Hurley Stages between the two groups (p=0.583). In our study, the residence of patients with HS living in food deserts was significantly associated with race and median income, but did not have any significant differences in HS outcomes. While food deserts may be a valuable indicator of socioeconomic status for patients with HS, our study did not find a significant impact of FD on the pathophysiology of HS.