title: Hidradenitis Suppurativa Management in the United States: An Analysis of the National Ambulatory Medical Care Survey and MarketScan Medicaid Databases.
abstract: OBJECTIVE
  To present nationally representative data demonstrating how frequently hidradenitis suppurativa (HS) occurs in specific groups and how it is currently managed.
  
  
  METHODS
  We analyzed data from the 1990-2009 National Ambulatory Medical Care Survey (NAMCS) and the 2003-2007 MarketScan Medicaid databases for patients with a diagnosis of HS (ICD-9-CM code 705.83). Visits per 100,000 population of each race and ethnicity were calculated using the 2000 US Census data for specific demographics.
  
  
  RESULTS
  There were 164,000 patient visits (95% CI: 128,000-200,000) annually with a diagnosis of HS in the NAMCS, and 17,270 HS patients were found in the MarketScan Medicaid over the 5-year period. Antibiotics were the most common treatment, followed by pain medications, topical steroids, and isotretinoin. Prescriptions of biologics and systemic methotrexate, cyclosporine, and acitretin were not observed in the NAMCS. Physicians prescribed medications in 74% of visits and used procedures in 11% of visits. African Americans, females, and young adults had higher numbers of visits for HS.
  
  
  CONCLUSIONS
  Our data showing a maximum of 0.06% of the population being treated for HS in a given year are consistent with the low estimates of HS prevalence. Compared to the current prescribing patterns, the more frequent prescription of biologics and systemic treatments may yield better outcomes.
authors.affiliation: Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, N.C., USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.affiliation: Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, Ind., USA.
authors.forename: Hsien-Chang
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Clinical, Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, Mich., USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.affiliation: Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, N.C., USA; Department of Pathologyand, Wake Forest School of Medicine, Winston-Salem, N.C., USA; Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, N.C., USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
keywords: Antibiotics; Apocrine glands; Biologics; Demographics; National Ambulatory Medical Care Survey; Tumor necrosis factor inhibitors