Hidradenitis suppurativa: epidemiological study of cases diagnosed at a dermatological reference center in the city of Bauru, in the Brazilian southeast State of São Paulo, between 2005 and 2015

Abstract

BackgroundHidradenitis is a chronic inflammatory disease of the hair follicles. A treatment is necessary due to chronicity and psychological changes that patient present.ObjectiveTo investigate epidemiological aspects and elaborate a risk group profile, promote early diagnosis and contribute to the knowledge about the disease.MethodsThis cross-sectional descriptive study with retrospective analysis of medical records of 194 patients diagnosed with hidrosadenitis in a dermatological reference center in the city of Bauru (SP) between 2005 and 2015.ResultsFemales accounted for 74% of cases. The age at diagnosis ranged from 10 to 67 years and the majority was within the 3rd and 4th decade of life. It occurred Association with diabetes mellitus in 33%, obesity in 55% and smoking in 61% was observed. Mean time between the onset of the disease and diagnosis was nine years. Hurley stage II was the most common at diagnosis. The therapeutic option mostly used in Hurley I and II was systemic antibiotics and in Hurley III was surgery.Study limitationsthe main limitation of this study is its retrospective design, which does not allow the true clinical confirmation of the disease by investigators.Conclusionwe outlined the following profile: women, caucasian, between 3rd and 4th decade of life, associated with obesity, smoking, late diagnosis and multiple potential therapeutic modalities. We highlight the importance of studies like this in order to identify risk groups and encourage early diagnosis.

Prevalence of hidradenitis suppurativa in Brazil: a population survey

“…Brazilian HS subjects were mainly adults between third and fourth decades, which corroborate the results of two previous hospital‐based Brazilian studies . The prevalence of the disease increases after puberty, according to apocrine glands maturity.…”

“…Hidradenitis suppurativa (HS) is a chronic and relapsing follicular autoinflammatory disorder that inflicts major impact in quality of life . Population prevalence studies of HS are scarce, especially in Latin America …”

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

“…Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM). Hence, there have been prior suggestions of an association between HS and DM, although the majority of reports to date demonstrate a wide range in terms of HS prevalence in patients with DM, as well as unadjusted analyses susceptible to confounder bias …”

Acne and hidradenitis suppurativa

“…Even though acne is a feature of polycystic ovarian syndrome, few studies have explored the association of a high BMI with acne, and some studies even suggest that patients with high BMI have a lower risk of acne . For HS, the association with BMI is much clearer . Obesity may have an impact on HS by mechanically increasing friction at flexural sites (thus potentially damaging follicular outlets), increasing sweat retention or increasing the circulating level of proinflammatory cytokines (IL‐1β and TNF‐α are both secreted by macrophages within visceral fat) .…”

“…161 For HS, the association with BMI is much clearer. 162,163 Obesity may have an impact on HS by mechanically increasing friction at flexural sites (thus potentially damaging follicular outlets), increasing sweat retention or increasing the circulating level of proinflammatory cytokines (IL-1b and TNF-a are both secreted by macrophages within visceral fat). 17 Circulating mononuclear cells reportedly exhibit a proinflammatory state in obese individuals (IL-6 and TNF-a gene expression is upregulated).…”