Hospitalisations with Hidradenitis Suppurativa: An Increasing Problem That Deserves Closer Attention

Abstract

Background/Aims: Hidradenitis suppurativa (HS), a chronic inflammatory skin disease of the hair follicle, can lead to scarring and disability. With an estimated European prevalence of 1%, few epidemiological studies of HS have been performed, and none focused on hospitalisations. We aimed to study the time trends of HS hospitalisations and to evaluate the demographic characteristics, hospital incidence rate, readmissions, length of stay, comorbidities and risk factors of hospitalised HS patients. Methods: We performed a retrospective observational study using a national administrative database in Portugal, with discharges between 2000 and 2014. All the inpatients aged 5 years or more with a diagnosis of HS were included. Variables analysed were age, sex, admission and discharge date, discharge outcome and diagnoses. Results: A total of 1,177 patients were hospitalised in this time period (48 were aged 18 years or younger) with a male-to-female ratio of 1:1.17. There was a hospital incidence rate of 0.83 patients with HS per 100,000 person-years (95% CI = 0.78-0.88). The age group with the highest incidence rate was 20-29 years among women and 40-49 years among men. We recorded an increasing trend in the number of new hospitalised patients and in the hospital incidence rate of HS. Tobacco was the most common comorbidity/risk factor. Eighty-three percent of our population underwent HS surgery. Conclusion: This hospital-based incidence study showed that admission for HS is increasing and that the majority of the HS inpatients were surgical cases. In the future, prospective studies will be important to assess risk factors for hospitalisations and complications.

Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross‐sectional study among 2465 patients

“…In the present cohort of 2465 patients with HS, using data from 14 centres from different countries, we observed a prevalence of 27% for IGF skin lesions. The exact prevalence remains elusive, but studies using diverse cohorts provide estimates of 4.6–30% for PSD in patients with HS . Therefore, a direct and statistically significant comparison with the general population is still warranted, but the proportion of PSD within this HS cohort seems to be higher than the 1–9% prevalence observed in the general population .…”

Update on Hidradenitis Suppurativa (Part I): Epidemiology, Pathogenesis, Severity assessment and Comorbidities

“…18,21 6. EPIDEMIOLOGY HS is an under recognized entity with a significant delay from the onset of symptoms to the diagnosis, 22,23 with a median delay of 12 years in one study. 24 Prevalence is a matter of debate, with estimated rates as low as 0.00033% up to 4%.…”

“…22 and involved areas also differ between genders, with the groin and submammary regions most commonly affected in women while the buttocks and perianal skin are the most affected areas in men. 22 Chronicity is the rule in HS. In a questionnaire survey the mean duration of the active disease was 18.8 years.…”

“…22 This ratio decreases in older patients as there is considerable evidence of a decline in prevalence in women after the age of 55 and not so evident in males, which may reflect hormonal changes due to menopause. 18,26 …”

Is the prevalence of hidradenitis suppurativa being overestimated in Europe? Or is the disease underdiagnosed? Evidence from a nationwide study across Portuguese public hospitals

“…In Europe, HS prevalence in the general population is estimated to be around 1%, although only few studies have assessed this prevalence . In a previous study, the authors reported an increasing trend in the HS hospital incidence rate. This study aims to measure the frequency of hospitalizations with HS in Portuguese public hospitals, during a 15‐year period, in order to estimate the proportion of HS patients who sought healthcare services.…”