Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Aug 1;157(8):924-931.
doi: 10.1001/jamadermatol.2021.1677.

Prevalence of Hidradenitis Suppurativa: A Systematic Review and Meta-regression Analysis

Abdulhadi Jfri  1 , David Nassim  2 , Elizabeth O'Brien  1 , Wayne Gulliver  3 , Georgios Nikolakis  4   5 , Christos C Zouboulis  4   5
Affiliations
Meta-Analysis

Prevalence of Hidradenitis Suppurativa: A Systematic Review and Meta-regression Analysis

Abdulhadi Jfri et al. JAMA Dermatol. .

Abstract

Importance: Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by occlusion of hair follicles as a primary pathogenic factor. There are scarce data regarding the prevalence of HS.

Objective: To estimate overall HS prevalence.

Data sources: This review and meta-regression analysis was conducted using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. The academic search included PubMed, Cochrane registry, ClinicalTrials.gov, and evidence by NHS UK and Trip databases from inception through May 2020. To analyze HS prevalence, only cross-sectional studies or baseline assessments of longitudinal cohorts using census-based surveys or probabilistic and nonprobabilistic epidemiologic methods were considered. The search terms were (prevalence OR incidence OR epidemiology) AND (hidradenitis suppurativa OR acne inversa OR Verneuil's disease). No language restriction was applied.

Study selection: Original investigations that reported HS prevalence were included. After exclusion criteria were applied, 17 studies qualified for qualitative analysis, but only 16 studies were quantitatively assessed.

Data extraction and measures: Two reviewers extracted data by age, diagnostic criteria, presence of any comorbidity, sample sizes, continent/location, sex, and other characteristics. Assessment of bias risk used the Joanna Briggs Institute Critical Appraisal Instrument for Studies Reporting Prevalence Data using random-effects models to synthesize available evidence.

Main outcomes and measures: Hidradenitis suppurativa prevalence (with 95% CI) among the overall population and among subgroups. Between-study heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic).

Results: In 16 quantitatively assessed studies included, prevalence estimates were reported only from Western European and Scandinavian countries, the US, and Australia. Meta-analysis with random effects, after adjusting for publication bias in the prevalence estimates, revealed a 0.40% prevalence (95% CI, 0.26%-0.63%) for HS. Studies based on clinical samples revealed a higher pooled prevalence of HS (1.7%) than population-based studies (0.3%).

Conclusions and relevance: The findings of this systematic review and meta-regression analysis may help facilitate policy formulation, channeling funding and guiding principles for better disease diagnosis using universal valid tools and management.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr O'Brien reported personal fees from AbbVie Pharmaceutical Ad board, speaker fees, consultant, grants from Galderma SKINPACT (educational project), personal fees from Therakos Consultant fees, and grants from AbbVie HS Quebec (patient support project) outside the submitted work. Dr Zouboulis reported receiving personal fees from Idorsia, Incyte, InflaRx, Janssen, Novartis, Regeneron, and UCB outside the submitted work. His departments have received grants from AbbVie, Inflarx, Novartis, and UCB for his contribution as clinical investigator outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Flow Diagram
HS indicates hidradenitis suppurativa.
Figure 2.
Figure 2.. Pooled Prevalence of Hidradenitis Suppurativa and Event Rates for Individual Population Studies
Squares represent mean values, with the size of the squares indicating weight and horizontal lines representing 95% CIs. The diamond represents the pooled mean with the points of the diamond representing 95% CI.
Figure 3.
Figure 3.. Pooled Prevalence of HS and Event Rates for Individual Clinical Studies
Squares represent mean values with 95% CIs, with the size of the squares indicating weight. The diamond represents the pooled mean with the points of the diamond representing 95% CI.
See this image and copyright information in PMC

References

    1. Kurzen H, Kurokawa I, Jemec GB, et al. . What causes hidradenitis suppurativa? Exp Dermatol. 2008;17(5):455-456. doi:10.1111/j.1600-0625.2008.00712_1.x - DOI - PubMed
    1. Jfri AH, O’Brien EA, Litvinov IV, Alavi A, Netchiporouk E. Hidradenitis suppurativa: comprehensive review of predisposing genetic mutations and changes. J Cutan Med Surg. 2019;23(5):519-527. doi:10.1177/1203475419852049 - DOI - PubMed
    1. Jfri A, Netchiporouk E, Raymond K, Litvinov IV, O’Brien E. Association of clinical severity scores with psychosocial impact in patients with hidradenitis suppurativa. J Am Acad Dermatol. 2020;S0190-9622(20)32410-5. doi:10.1016/j.jaad.2020.08.022 - DOI - PubMed
    1. Ingram JR, Jenkins-Jones S, Knipe DW, Morgan CLI, Cannings-John R, Piguet V. Population-based clinical practice research datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. Br J Dermatol. 2018;178(4):917-924. doi:10.1111/bjd.16101 - DOI - PubMed
    1. Kjaersgaard Andersen R, Saunte SK, Jemec GBE, Saunte DM. Psoriasis as a comorbidity of hidradenitis suppurativa. Int J Dermatol. 2020;59(2):216-220. doi:10.1111/ijd.14651 - DOI - PubMed