160 Monocentric Retrospective Analysis of the Dermatological Care Situation of Hidradenitis Suppurativa (HS) Patients in Urban and Rural Regions of Bavaria

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that has a devastating impact on patients' quality of life. Therapy largely relies on oral / topical antibiotics and surgery with limited success regarding long term remissions; immunomodulatory drugs such as TNF-alpha inhibitors and IL17 inhibitors are more effective but used hesitantly by many physicians. The lack of access to specialist care in rural areas could lead to a considerable delay in diagnosis and to insufficient treatment of HS. Aim of the study: To specify the dermatological care situation of patients with HS in urban and rural regions in Bavaria. Methods: Monocentric retrospective analysis of patient records of HS patients in University Hospital Regensburg between 2019 and 2021. Results: We analyzed 192 patient records of confirmed HS cases. Over 90 % of the patients were not from the city of Regensburg but from surrounding regions (mainly rural). Before the initial presentation to the university hospital, the proportion of patients who received systemic antibiotics(ab), antibiotic creams(cr) or TNF-alpha inhibitors(tnf) for treatment is lower in those patients who are not directly from Regensburg ([ab]=29%, [ac]=7%, [tnf]=4%) compared to those directly from the city ([ab]=50%, [ac]=25%, [tnf]=6%). In contrast, during follow-up treatment at the University Hospital, the proportions switch (residence outside Regensburg [ab]=66%, [cr]=64%, [tnf]=15% compared to Regensburg [ab]=56%, [cr]=31%, [tnf]=6%) potentially indicating a higher disease severity. Moreover, 50% of the patients were referred by dermatologists and 46% were referred with the diagnosis “Acne inversa/HS” or “suspected Acne inversa/HS”, however no information was provided for 37% of patients. Discussion/ Conclusion: This preliminary evaluation indicates that the care situation of HS patients in rural areas of Bavaria needs improvement regarding the use of Immunomodulatory drugs and that specialized academic teaching hospitals are paramount in establishing the diagnosis and state of the art the treatment.