There are inequities when it comes to race in the medical sphere, just as there are in every other facet of life. One specific issue pertains to clinical trials, as white patients are typically the ones included in research. Because of this, medical professionals have less knowledge when it comes to treating patients of color, often resulting in different treatment courses. An article published in Healio illustrates how this occurs for people of color being treated for hidradenitis suppurativa (HS).

What is HS?

First, it’s important to understand what exactly hidradenitis suppurativa is. According to the Mayo Clinic, HS is characterized by small and painful lumps that form under the skin. They are most common where the body rubs against itself, such as the armpits, buttocks, groin, and breasts. They heal slowly and recur as well, leading to scarring and tunnels. Blackheads and leaking bumps/sores are other symptoms.

Medical professionals aren’t exactly sure as to why this condition occurs, but they do know that the lumps form when hair follicles become blocked. They’ve also identified a number of risk factors: being in your 20s or 30s, smoking, being female, a family history of the condition, being Black, being obese, and having certain conditions (arthritis, diabetes, IBD, and metabolic syndrome). Treatment consists of medication and surgery to remove the lumps, drain pus, and uncover tunnels.

Differences in Treatment

A recent study performed in South Carolina uncovered that HS patients of color are more likely to be treated surgically than their white counterparts. Data was presented in a poster at the Skin of Color Update virtual meeting.

Researchers conducted this cross-sectional retrospective study, performing chi-square analyses and descriptive statistics of various appointments and procedures used to treat HS patients. They found that white patients had a higher chance of being prescribed thyroid replacement hormones and mood disorder agents, whereas patients of color were more likely to be treated with NSAIDs and metformin. Additionally, 68.5% of white patients were treated with triamcinolone injections but only 60.9% of patients of color were given the same.

Patients of color were more likely to be treated with surgery, as the researchers found that 11.6% of this group underwent a complex excision compared to just 5.5% of white patients. There are numerous reasons that could be behind this difference, but more research is necessary to know what they are for sure. As of now, medical professionals suspect that racial and socioeconomic bias and status may play a role, as does a delay in diagnosis. One researcher stated,

“Although HS is more prevalent in patients with skin of color, research in HS has historically been performed in European and white populations.”