Hidradenitis Suppurativa Phenotypic Heterogeneity: A Single Center Latent Class Analysis of 532 patients

Hidradenitis suppurativa (HS) is a heterogenous chronic inflammatory skin disease that lacks consensus regarding phenotypic classification. A stratification system of HS phenotypes may help individualize treatment and ensure accurate and timely diagnosis. This study aims to identify HS phenotypes using latent class analysis (LCA) to contribute to understanding of the disease. A total of 532 patients with HS were included from the outpatient dermatology clinics of Michigan Medicine in Ann Arbor, Michigan, USA. Two distinct HS phenotypes were identified. Latent class 1 (Axillary-Genital-Mammary) comprised 29.1% of patients and showed higher probabilities for severe axillary, genital, and mammary involvement. Latent class 2 (Axillary-Genital-Gluteal) included 70.9% of patients and had higher probabilities for mild axillary, genital, and gluteal involvement. Axillary-Genital-Mammary had an earlier age of onset, shorter disease duration, and a higher proportion of former smokers. This study identified two distinct HS phenotypes: a severe Axillary-Genital-Mammary and milder Axillary-Genital-Gluteal phenotype. Tailoring treatments based on phenotype-specific characteristics may improve outcomes. The study contributes to the growing understanding of HS phenotypes in the US population, offering insights for more individualized disease management.