Incidence, Risk Factors, and Prognosis of Hidradenitis Suppurativa Across the Globe: Insights from the Literature

Abstract

Hidradenitis suppurativa, a chronic inflammatory disease of the skin, affects a patient’s quality of life to a greater extent. While the disease burden, including its incidence and prevalence, has been extensively studied in the western population, there is a paucity of data from developing countries on the epidemiology of Hidradenitis suppurativa. Therefore, a general literature review was conducted to shed light on the epidemiology of Hidradenitis suppurativa across the globe. We reviewed the most recently available information on epidemiology, including incidence, prevalence, risk factors, prognosis and quality of life, complications, and associated comorbid among patients with Hidradenitis suppurativa. The estimated global prevalence of Hidradenitis suppurativa is found to be 0.00033–4.1%, with a relatively higher prevalence of 0.7–1.2% in European and US populations. Both genetic and environmental factors are associated with Hidradenitis suppurativa. Patients with Hidradenitis suppurativa have associated comorbid such as cardiovascular disease, type II diabetes mellitus, mental health issues, and sleep and sexual dysfunctions. These patients spend poor quality of life and tend to be less productive. Future studies are needed to assess the burden of Hidradenitis suppurativa in developing countries. Since the disease tends to be underdiagnosed, future studies should rely on clinical diagnosis rather than self-reporting to avoid the potential of recall bias. Attention needs to be diverted to developing countries with less amount of data on Hidradenitis suppurativa.

Very low-calorie ketogenic diet (VLCKD) in the management of hidradenitis suppurativa (Acne Inversa): an effective and safe tool for improvement of the clinical severity of disease. Results of a pilot study

“…In the present study, it is essential to recognize certain limitations: (a) The sample was limited, and this may have affected the generalizability of the results. However, HS is a relatively rare disease with an overall incidence of approximately 0.00033–4.1% [ 61 ]; (b) Lack of a control group. However, for the short treatment period, a comparison with another diet, such as the Mediterranean diet, would have been ineffective, requiring a longer period for comparable results; (c) The sample included only women, limiting consideration of the effect of VLCKD on men.…”

Discovering KYNU as a feature gene in hidradenitis suppurativa

“…The follicular occlusion tetrad can be formed when the triad is concomitantly present with pilonidal sinus. 43 The comorbidities commonly associated with HS primarily encompass autoimmune diseases, including ulcerative colitis, Crohn's disease, and seronegative spondyloarthropathies. 44,45 A meta-analysis of observational studies involving 6174 HS patients and 24,993 controls found significant associations between HS and obesity, central obesity, smoking (both active and history), hypertriglyceridemia, low high-density lipoproteins, diabetes, and metabolic syndrome.…”

The Role of FDG-PET in the Evaluation of Hidradenitis Suppurativa: A Systematic Review

“…One study found that lesions of HS patients on prolonged antibiotics grew significantly more antibiotic-resistant bacteria. These results underscore the importance of antibiotic stewardship when managing HS [23]. Alternatively, hormonal treatments such as oral contraceptives, spironolactone, and finasteride have also been used as adjuncts in severe disease or in mild-to-moderate presentations.…”

“…Alternatively, hormonal treatments such as oral contraceptives, spironolactone, and finasteride have also been used as adjuncts in severe disease or in mild-to-moderate presentations. As increased levels of androgens cause the folliculopilosebaceous gland to secrete more sebum, the mechanism of hormone therapy to treat HS functions by balancing testosterone and 5-dihydrotestosterone (5-DHT) levels [23]. Severe cases may require treatments like adalimumab, intravenous carbapenems, isotretinoin, laser therapy, and surgical excision.…”

“…Surgical interventions for HS encompass procedural approaches like laser therapy and minor surgical procedures, including incision and drainage or deroofing. A more extensive surgical option for severe disease would be wide local excision [23]. Laser Speckle Contrast Analysis (LASCA) is an innovative tool with diverse applications in dermatology and dermatosurgery.…”