Presentation and progression of hidradenitis suppurativa

Hidradenitis suppurativa typically has an early onset, often in teenage girls, while men are usually diagnosed in their early 20s, Porter said, and a much smaller population develops new, more rapidly progressing disease in middle age. Some patients are early fast progressors who reach Hurley stage 3 within six months; others take two to 10 years to progress; and some never advance past early stage 2, but there are no good tests to predict which course a patient will follow, she notes. Teenagers with lesions in sensitive areas, such as the genitals or under the breasts, may hide their symptoms out of embarrassment and end up with more severe, longer-lasting disease. Even mild hidradenitis suppurativa can cause patients to miss school and work, Porter said, and hospitalization rates rise rapidly once patients reach young adulthood.