Hidradenitis suppurativa in East and Southeast Asian populations: a systematic review and meta‐analysis

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that presents with recurrent inflammatory nodules and draining tunnels in the skin. Most HS studies have focused on Western populations, and the understanding of how HS characteristics differ in specific Asian ethnicities is poor. We conducted the first systematic review and metaanalysis to characterize HS patients from East and Southeast Asia. PubMed, Embase, and Ovid MEDLINE databases were searched from inception to June 12, 2020. Englishlanguage case-series, cross-sectional, observational, and randomized controlled trial studies investigating HS in East and Southeast Asian populations were screened by titles, abstracts, and articles in duplicate. Of 136 citations, 10 studies were included in the meta-analysis. Data on gender distribution, lesion distribution in the axilla and gluteal regions, and family history were extracted in duplicate. A random effects model was used for the meta-analysis. A total of 30,125 HS patients were included in the analysis. Most patients were male (66%, 95% CI = 60-72%). About half of Asian patients with HS develop lesions in the axilla (52%, 95% CI = 33-72%) and the buttocks (48%, 95% CI = 38-57%). Only a small subset had positive family history of HS (5%, 95% CI = 2-8%). We report an up-to-date characterization of HS in East and Southeast Asian populations and highlight differences in their Western counterparts. These results will hopefully improve understanding for how HS may manifest, lead to more personalized treatments for Asian patients with HS, and usher in a proper patient-centered approach to treating the disease.

Overall Impairment of Quality of Life in Japanese Patients with Hidradenitis Suppurativa: Comparison with National Standard

“…Thirdly, there is considerable male predominance. Patients with HS in the Far East region show a male predominance ( 14 ). Reports from Western countries indicate that female patients with HS have higher DLQI ( 11 ).…”

Recent advances in hidradenitis suppurativa: Role of race, genetics, and immunology

“…In addition, a recent metaanalysis focusing on East and Southeast Asian populations notably lacked randomized-controlled trials but did include several cross-sectional cohorts and case-based studies. In contrast to HS in the Western regions, in these populations, HS tended to preferentially affect males, the axillary and gluteal regions, and report a lower rate of positive family history (5 versus 30%) (Gotesman et al, 2021). While environmental variables including smoking and obesity are proposed explanations for these differences, underrepresentation of these populations in genetic studies is likely to be a significant contributor, given that a large proportion of available targeted genetic studies on familial HS are described in Asian patients (particularly γ-secretase mutations) (Van Straalen et al, 2022).…”

Dissecting cellulitis of the scalp with typical clinical features: A retrospective cross‐sectional study in a Department of Dermatology, Beijing, China

“…HS is an analogous disease of DCS. The prevalence of HS for women was more than twice that for men in the US population, but most Asian patients were men 15–17 . Interestingly, there seemed to be no gender difference in the Taiwanese population, which was different from other Asian countries 16,17 .…”

“…The prevalence of HS for women was more than twice that for men in the US population, but most Asian patients were men. [15][16][17] Interestingly, there seemed to be no gender difference in the Taiwanese population, which was different from other Asian countries. 16,17 These also might be the reasons that our study has not included the female patients and differed from American and Taiwanese studies.…”