Clinical phenotypes and risk factors of hidradenitis suppurativa: A retrospective study of 57 Moroccan patients

Background : Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis. It is a challenging disease characterized by a clinical phenotypic heterogeneity. Clinical phenotypes of HS have different epidemiological and evolutive features, with a significant impact on the therapeutic management. To our days, literature data concerning clinical phenotypes of HS still scarce. Methods : We conducted a retrospective descriptive study in a Moroccan population, to identify the main clinical phenotype of HS and its risk factors, as a primordial step towards a personalized approach in the management of HS. Results : Fifty-seven patients were included. Gluteal phenotype (LC2) was the most represented (85.96%).The mean age of onset of symptoms in this group was 31years old.A male predominance (77.41%) was observed. Acne in adolescence was found in 18 patients (36.73%).Thirty-nine patients (79.59%) were active smokers. Fourteen patients (29.16%) had a prolonged sitting position. Their professional occupation was:drivers (n=10), shopkeepers(n=3) and secretaries (n=1).Five patients (10.20%) had a family history of hidradenitis suppurativa. Mean body mass index was 23.87. Follicular phenotype (LC3) was observed in 8 patients (14.03%).The average age of onset of symptomatology was 37 years old. A female predominance was noted(62.5%).Acne was found in 3 patients(37.5%),active smoking in 2 patients (25%).Mean body mass index was 22.83. Axillary-mammary phenotype (LC1) was observed only in a 15-year-old non-smoking girl in overweight presenting intermammary fold fistulas. Conclusions : The predominance of the gluteal phenotype in our population may be related to genetic factors, intestinal microbiota and prolonged gluteal friction.Large-scale analytical studies are needed to support these hypothesis.