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.

化脓性汗腺炎（Hidradenitis suppurativa, HS）是一类异质性慢性炎症性皮肤病，目前其表型分类尚未形成广泛共识。构建HS表型分层系统，有助于实现个体化治疗，并保障精准及时的疾病诊断。本研究旨在通过潜在类别分析（latent class analysis, LCA）识别HS表型，以深化对该疾病的认知。

本研究共纳入来自美国密歇根州安阿伯市密歇根医学中心皮肤科门诊的532例HS患者，最终明确了两种截然不同的HS表型：潜在类别1（腋窝-生殖器-乳腺型）占全部受试者的29.1%，该类人群出现严重腋窝、生殖器及乳腺受累的概率显著更高；潜在类别2（腋窝-生殖器-臀型）占比70.9%，其轻度腋窝、生殖器及臀区受累的概率更高。

腋窝-生殖器-乳腺型患者的发病年龄更早、病程更短，且既往吸烟者的占比更高。本研究鉴定出两种差异化的HS表型：重症型腋窝-生殖器-乳腺表型与轻症型腋窝-生殖器-臀表型。基于表型特异性特征定制治疗方案，或可改善疾病预后。本研究有助于深化对美国人群HS表型的认知，为更具个体化的疾病管理提供参考依据。