Familial Hidradenitis Suppurativa on the Island of Crete: Distinct Patterns in Clinical Characteristics

ABSTRACT Background This study aimed to compare the clinical characteristics and comorbidities of patients with hidradenitis suppurativa (HS) who have a first‐degree family history (FH) of the disease to those without. Methods This cross‐sectional study was conducted at the Dermatology Department of the University Hospital of Heraklion, Greece, from January 2022 to April 2025. Adult consecutive HS patients were enrolled. Detailed demographic, clinical, and comorbidity data were collected, and disease severity was assessed using multiple scoring systems, including the Sartorius score, Hurley stage, and IHS4. Familial HS was diagnosed clinically. Using Jamovi Windows Version 2.7.2, statistical analysis was performed to identify potential associations between FH status and clinical characteristics. Results A total of 170 HS patients were enrolled, of whom 30% (51/170) reported a first‐degree FH of HS, while 70% (119/170) had no FH. Patients with a FH were more likely to be female (70.6% vs. 52.9%, p = 0.024) and experienced earlier disease onset (21.47 ± 8.74 years vs. 24.67 ± 10.58 years, p = 0.024). FH patients were more frequently classified as Hurley stage 2 (62.7% vs. 42.0%, p = 0.025). Patients with familial HS had significantly higher rates of atopy (25.5% vs. 12.6%, p = 0.038) and psychiatric disorders (33% vs. 5.9%, p = 0.000). Also, a statistically significant association was found between gender and the presence of atopy among patients with hidradenitis suppurativa ( p = 0.017). Female patients were more likely to report atopic conditions than male patients. Conclusion HS patients with a first‐degree FH exhibit distinct clinical characteristics, including earlier disease onset, female predominance, and higher prevalence of atopy and psychiatric disease. These findings may highlight the potential genetic or environmental links between gender, atopy, and psychiatric diseases in familial cases and underscore the need for further research into the underlying mechanisms.