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Itchy painful palms

Can you recognise Hidradenitis suppurativa (HS) as it presents in children? Lucina appreciates it is rare, but it is there. It is missed and not recognised. There is a significant time lag between first presentation of symptoms and diagnosis as suggested by the large proportion of patients who present with scarring at diagnosis. Perhaps this can be prevented if diagnosed earlier. Often patients with paediatric HS are likely to present with other comorbidities and have complications from their disease. Liy-Wong C et al [JAMA Dermatol. doi:10.1001/jamadermatol.2020.5435] have described this condition in a large international multicentre, retrospective, cross-sectional study of 481 paediatric patients. Associated symptoms are pain and tenderness, clamminess, malodor, pruritus and sometimes an associated fever. The team reviewed the medical records of paediatric patients (aged 1–18 years) with a clinical diagnosis of HS carried out in 10 dermatology clinics across the US, Canada, Israel, Australia, and Italy from January 1996 to January 2017. Overall, 386 (80%) were girls. The mean (SD) age of disease onset was 12.5 (2.9) years, and the mean (SD) age at diagnosis was 14.4 (3.5) years. Family history of HS was present in 111 of 271 (41%) patients. First signs/symptoms reported …

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