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Methods| With ethics board approval from all participating institutions, deidentified data from the medical records of 1203 patients with dermatologist-confirmed cases of HS from 3 North American HS practices were aggregated. Collected data included age at visit, sex, race, self-identified ethnicity, selfreported age at HS onset, and disease severity by Hurley stage. All analyses were conducted using R software, version 3.5. 0. Wilcoxon tests were used to compare age at onset across sex, race, and disease severity. Cullen-Frey plots were used to identify age at onset as a log-normal distribution, and χ2 tests were used to test for scale and location mixtures if the onset distribution came from a unique population or was a mixture of distributions representing distinct subpopulations. Because sex was significantly associated with age at onset, mixture of regression with sex as a covariate was used, allowing identification …