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Seasonal Trends of Ambulatory Visit Burden in Hidradenitis Suppurativa Patients

Introduction: Patients with hidradenitis suppurativa (HS) report HS flares with increased heat and sweat. However, there is a paucity of literature on whether there is an increased ambulatory visit burden for HS patients during the warmer months. 
Methods: We used a nationally-representative database of ambulatory visits in the United States, the National Ambulatory Medical Care Survey to examine the seasonal trends of ambulatory visits for patients with HS. Data analyses were performed using SAS Studio 9.04.01 (SAS Institute, Cary, N.C., USA), and variance in the complex survey design is accounted for by utilizing survey weights to create national estimates and confidence intervals. 
Results: We identified approximately 2.33 million outpatient visits (95% confidence interval 1.95 million-2.71 million) between 2008-2018 with a diagnosis of HS. Approximately 21% of visits occurred during Winter to early Spring (January to April), 51% during late Spring to Summer (May to August), and 28% during Autumn (September to December). The number of visits differed significantly between these three time periods (X2=13.1, p=0.0014). 
Conclusion: Awareness of the increased burden of HS during summer months may help guide management, including anticipatory counseling on strategic lifestyle modifications and initiation of anti-hyperhidrosis treatments.