{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:08:13Z","timestamp":1788563293914,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:00:00Z","timestamp":1702857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hidradenitis suppurativa (HS) is a chronic-relapsing inflammatory skin disease. It usually appears in the second and third decades, but a smaller proportion of patients develop late-onset HS. Geriatric HS, defined as the persistence or the development of HS after the age of 65 years, has been poorly explored. This study aimed to investigate the clinical features, treatment management and response to therapies of HS elderly subjects (\u226565 years old). We designed a multicentric observational study, gathering data from seven Italian university hospitals. Demographic and clinical data of HS patients aged over 65 years were collected at baseline, week 12 and week 24. Overall, 57 elderly subjects suffering from HS were enrolled. At baseline, disease severity was predominantly moderate-to-severe, with 45.6% of patients classified as Hurley III. The gluteal phenotype was the most frequently observed; it also appeared to affect patients\u2019 quality of life more than other phenotypes. Gluteal involvement was detected in about half (49.1%) of cases and associated with severe stages of the disease. In terms of therapeutic response, Hurley III patients showed the persistency of higher values of mean IHS4, DLQI, itch- and pain-NRS scores compared to Hurley I\/II. In conclusion, disease severity in this subpopulation appears high and treatment is often challenging.<\/jats:p>","DOI":"10.3390\/jcm12247754","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T10:04:47Z","timestamp":1702893887000},"page":"7754","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Features and Response to Treatment in Elderly Subjects Affected by Hidradenitis Suppurativa: A Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Flaminia","family":"Antonelli","sequence":"first","affiliation":[{"name":"Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ippoliti","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4227-7847","authenticated-orcid":false,"given":"Elia","family":"Rosi","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0060-5870","authenticated-orcid":false,"given":"Chiara","family":"Moltrasio","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalma","family":"Malvaso","sequence":"additional","affiliation":[{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Botti","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"},{"name":"Dermatology Unit, Fondazione Policlinico \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Abeni","sequence":"additional","affiliation":[{"name":"Istituto Dermopatico dell\u2019Immacolata, IDI-IRCCS, Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Dini","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Cannizzaro","sequence":"additional","affiliation":[{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfredo","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"},{"name":"Dermatology Unit, Ospedale San Salvatore, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Di Nardo","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7249-2556","authenticated-orcid":false,"given":"Maria Concetta","family":"Fargnoli","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"},{"name":"Dermatology Unit, Ospedale San Salvatore, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-0141","authenticated-orcid":false,"given":"Marco","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Fania","sequence":"additional","affiliation":[{"name":"Istituto Dermopatico dell\u2019Immacolata, IDI-IRCCS, Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8697-6896","authenticated-orcid":false,"given":"Luca","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"},{"name":"Dermatology Unit, Fondazione Policlinico \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-4169","authenticated-orcid":false,"given":"Angelo Valerio","family":"Marzano","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5997-2045","authenticated-orcid":false,"given":"Francesca","family":"Prignano","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketty","family":"Peris","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-0387","authenticated-orcid":false,"given":"Andrea","family":"Chiricozzi","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. 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J. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/bjd.19435","article-title":"The epidemiology of hidradenitis suppurativa","volume":"183","author":"Ingram","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1016\/j.jaad.2021.02.075","article-title":"Late-onset hidradenitis suppurativa: A cluster analysis of the National Italian Registry IRHIS","volume":"85","author":"Cazzaniga","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1001\/jamadermatol.2022.5390","article-title":"Hidradenitis Suppurativa in Older Adults","volume":"159","author":"Blum","year":"2023","journal-title":"JAMA Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"van der Weijden, D.A.Y., Koerts, N.D.K., van Munster, B.C., van der Zee, H.H., and Horv\u00e1th, B. (2023). Hidradenitis suppurativa tarda: Defining an understudied elderly population. Br. J. Dermatol., ljad317.","DOI":"10.1093\/bjd\/ljad317"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Nielsen, V.W., Ring, H.C., Holgersen, N., and Thomsen, S.F. (2023). Elderly male patients with hidradenitis suppurativa have more severe disease independent of disease duration. Br. J. Dermatol., ljad411.","DOI":"10.1093\/bjd\/ljad411"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"White, J.M., and Del Marmol, V. (2023). Hidradenitis suppurativa in the elderly: New insights. Br. J. Dermatol., ljad378.","DOI":"10.1093\/bjd\/ljad378"},{"key":"ref_10","first-page":"274","article-title":"Hidradenitis Suppurativa in Postmenopause","volume":"17","author":"Cucu","year":"2021","journal-title":"Acta Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1097\/DCR.0000000000001497","article-title":"Hidradenitis Suppurativa","volume":"62","author":"Kawak","year":"2019","journal-title":"Dis. Colon. Rectum."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1038\/jid.2012.472","article-title":"Identification of three hidradenitis suppurativa phenotypes: Latent class analysis of a cross-sectional study","volume":"133","author":"Revuz","year":"2013","journal-title":"J. Investig. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1145152","DOI":"10.3389\/fmed.2023.1145152","article-title":"Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data","volume":"10","author":"Daoud","year":"2023","journal-title":"Front. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1111\/bjd.15748","article-title":"European Hidradenitis Suppurativa Foundation Investigator Group. Development and validation of the International Hidradenitis Suppurativa Severity Score System (IHS4), a novel dynamic scoring system to assess HS severity","volume":"177","author":"Zouboulis","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/bjd.20765","article-title":"A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI), DLQI-Relevant and Skindex-16","volume":"186","author":"Brodszky","year":"2022","journal-title":"Br. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2230.1994.tb01167.x","article-title":"Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use","volume":"19","author":"Finlay","year":"1994","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1001\/jamadermatol.2019.0478","article-title":"Distribution of Self-reported Hidradenitis Suppurativa Age at Onset","volume":"155","author":"Naik","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1093\/bjd\/ljac121","article-title":"Association between age at symptom onset and disease severity in older patients with hidradenitis suppurativa","volume":"188","author":"Jiang","year":"2023","journal-title":"Br. J. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1046\/j.1468-3083.2000.00087.x","article-title":"The natural history of hidradenitis suppurativa","volume":"14","author":"Williams","year":"2000","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1177\/1203475419852049","article-title":"Hidradenitis Suppurativa: Comprehensive Review of Predisposing Genetic Mutations and Changes","volume":"23","author":"Jfri","year":"2019","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1016\/j.jaad.2015.07.047","article-title":"New insights into the diagnosis of hidradenitis suppurativa: Clinical presentations and phenotypes","volume":"73","author":"Jemec","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.jid.2020.08.032","article-title":"Characterization of Hidradenitis Suppurativa Phenotypes: A Multidimensional Latent Class Analysis of the National Italian Registry IRHIS","volume":"141","author":"Cazzaniga","year":"2021","journal-title":"J. Investig. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1007\/s10875-023-01518-3","article-title":"Inborn Errors of Immunity in Hidradenitis Suppurativa Pathogenesis and Disease Burden","volume":"43","author":"Colvin","year":"2023","journal-title":"J. Clin. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Palmroth, M., Viskari, H., Sepp\u00e4nen, M.R.J., Keskitalo, S., Virtanen, A., Varjosalo, M., Silvennoinen, O., and Isom\u00e4ki, P. (2021). IRF2BP2 Mutation Is Associated with Increased STAT1 and STAT5 Activation in Two Family Members with Inflammatory Conditions and Lymphopenia. Pharmaceuticals, 14.","DOI":"10.3390\/ph14080797"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1159\/000529848","article-title":"Tunnels in Hidradenitis Suppurativa: Active Inflammatory Entities with Specific Molecular and Genetic Profiles\u2014A Narrative Review","volume":"239","author":"Krajewski","year":"2023","journal-title":"Dermatology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"adv00172","DOI":"10.2340\/00015555-3520","article-title":"Clinical and Ultrasonographic Profile of Adalimumab-treated Hidradenitis Suppurativa Patients: A Real-life Monocentric Experience","volume":"100","author":"Chiricozzi","year":"2020","journal-title":"Acta Derm. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/jdv.16677","article-title":"Hidradenitis suppurativa: An update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life","volume":"35","author":"Nguyen","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1111\/bjd.14038","article-title":"Diagnostic delay in hidradenitis suppurativa is a global problem","volume":"173","author":"Saunte","year":"2015","journal-title":"Br. J. Dermatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/24\/7754\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:40:43Z","timestamp":1760132443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/24\/7754"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,18]]},"references-count":28,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jcm12247754"],"URL":"https:\/\/doi.org\/10.3390\/jcm12247754","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,18]]}}}