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. 2025 Aug 27:e252373.
doi: 10.1001/jamadermatol.2025.2373. Online ahead of print.

Prevalence of Hidradenitis Suppurativa: A Meta-Analysis of Global Hidradenitis Suppurativa Atlas Studies

Dorra Bouazzi  1   2   3 , Sabrina M Nielsen  3   4 , Paa G Hagan  5   6 , Sofia Botvid  2   7 , Lone S Hove  7 , Errol P Prens  8   9 , Robin Christensen  3   4 , Gregor B E Jemec  1   2   9 ; GHiSA Group; Klaudia Knecht-Gurwin  9   10 , Jacek C Szepietowski  9   11   12 , Ehiaghe L Anaba  13 , Ahmed S Chehad  14 , Samira Zobiri  15 , Amina Serradj  16 , Mohammed S I Bhuiyan  17 , Towhida Noor  18 , Philippe Guillem  9   19   20   21 , Mohammad M Parvizi  22 , Nasrin Saki  23 , Erkan Alpsoy  24 , Caner Vardar  24 , Theodora Kanni  25 , Evangelos J Giamarellos-Bourboulis  25 , John W Frew  26   27   28 , Waleed H A Al Maharbi  29 , Johanna C van Huijstee  8 , Pim Aarts  8 , Shinta T Dewi  30 , Sri A Febriana  30 , Niken Indrastuti  30 , Nyoman Suryawati  31 , Miranti Pangastuti  32 , Aryani Adji  33 , Gardenia Akhyar  34 , Nopriyati Nopriyati  35 , Cut P Hazlianda  36 , Francisco Reyes-Baraona  37 , Carlos Matas  37 , Haroon Saeed  38 , Ameshin Moodley  38 , Yousef Binamer  39 , Moonyza A A Kamil  40 , Ivana Jocic  41 , Zeljko Mijuskovic  41 , Kanchana Mallawaarachchi  42 , Chathurika Gangani  43 , Ivana Tusheva  44 , Vesna B Boshkovski  44 , Danchen Hu  45 , Songmei Geng  45 , Cecilia E Medianfar  1   2 , Ditte M L Saunte  1   2 , Nisha S Chandran  46 , Hessel H van der Zee  8   9 , Christos C Zouboulis  9   47 , Farida Benhadou  9   48 , Bente Villumsen  49 , Afsaneh Alavi  9   50 , Perpetua U Ibekwe  51 , Iltefat H Hamzavi  9   52 , John R Ingram  9   53 , Haley B Naik  9   54   55 , Amit Garg  9   56 , Jurr Boer  57
Affiliations

Prevalence of Hidradenitis Suppurativa: A Meta-Analysis of Global Hidradenitis Suppurativa Atlas Studies

Dorra Bouazzi et al. JAMA Dermatol. .

Abstract

Importance: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a substantial burden. Standardized global prevalence estimates and data on associated sociodemographic and risk factors are lacking.

Objective: To estimate the global prevalence of HS and study differences in prevalence by age, sex, geographical location, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), smoking status, gross domestic product (GDP), and Human Development Index (HDI).

Data sources and study selection: Included studies were conducted using the standardized Global Hidradenitis Suppurativa Atlas methodology with finalized data collection before May 19, 2023. Studies were required to use a population-based sampling method and conduct clinical confirmation of HS diagnosis following a screening questionnaire.

Data extraction and synthesis: Data were independently extracted from relevant studies by 2 reviewers (D.B. and C.E.M.) using a standardized form. Extracted variables included geographic location, age, sex, BMI (median and BMI >30), smoking status, HS prevalence estimates (with 95% CIs), GDP, and HDI. A proportional meta-analysis using a random-effects model was conducted on the included studies.

Main outcomes and measures: The primary outcome was the point prevalence of HS, confirmed by clinical examination. Secondary outcomes included differences in HS prevalence by sex, age, BMI category, smoking status, and country-level socioeconomic indicators (GDP and HDI). All outcomes were prespecified before data analysis.

Results: The sample included 22 743 participants, identifying 247 patients with HS, across 25 studies in 23 countries spanning 6 continents. The median proportion of female patients with HS was 55.6%, and the median age was 34.5 years. While the prevalence estimates showed considerable inconsistency (I2 > 75%; τ2 = 0.747), the overall random-effects global prevalence of HS was 0.99% (95% CI, 0.67%-1.46%). Female sex was the only factor observed to be associated with the prevalence estimates (β = 1.02; 95% CI, 1.01-1.03).

Conclusions and relevance: In this meta-analysis, an estimated global prevalence of HS between 0.67% and 1.46% surpassed previous global estimates. Substantial global variations in HS prevalence were also observed. Female sex was the only factor associated with prevalence in this sample. Future studies assessing genetic, environmental, and etiological factors are warranted to explain the heterogeneity in prevalence.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Bouazzi reported honoraria from UCB Nordic for EADV Congress participation in 2022 and 2023. Prof Jemec reported grants from the LEO Foundation and the International League of Dermatological Societies during the conduct of the study; personal fees from UCB, Novartis, MoonLake, and Eli Lilly; grants from UCB and Novartis; and a patent for HISTORIC Tools with royalties paid outside the submitted work. Prof Szepietowski reported personal fees from Novartis, AbbVie, Pierre Fabre, UCB, Sanofi-Genzyme, Pfizer, LEO Pharma, Teva, Almirall, and Eli Lilly outside the submitted work. Prof Giamarellos-Bourboulis reported Horizon Europe grants paid to the Hellenic Institute for the Study of Sepsis from Homi-Lung, POINT, EPIC-CROWN, ImmunoSep, and Abbott Products Operations; grants paid to the Hellenic Institute for the Study of Sepsis from bioMerieux and Swedish Orphan BioVitrum; personal fees paid to the National and Kapodistrian University of Athens from Abbott Products Operations, Swedish Orphan Biovitrum, Biotest, Bio-Rad, bioMerieux, and AbbVie; and grants paid to the National and Kapodistrian University of Athens from UCB, Novartis, Sanofi, AbbVie, and Incyte outside the submitted work. Prof Frew reported grants from UCB and Almirall, as well as personal fees from Boehringer Ingelheim, Janssen, AbbVie, Novartis, Bristol Myers Squibb, LEO Pharma, Takeda, Sanofi, Eli Lilly, and Amgen during the conduct of the study. Prof Saunte reported personal fees from UCB, Jamjoom Pharma, LEO Pharma, Galderma, and Novartis; travel grants from Novartis, UCB, Pfizer, and LEO Pharma; and serving as an Associate Editor for Dermatology and section editor for the Journal of the European Academy of Dermatology and Venereology outside the submitted work. Dr van der Zee reported personal fees from Novartis, UCB, AbbVie, Insmed, and Incyte outside the submitted work. Prof Zouboulis reported personal fees from Almirall, Biogen, Boehringer Ingelheim, CSL Behring, Eli Lilly, Estée Lauder, Idorsia, Incyte, L’Oréal/Vichy, MSD, NAOS/Bioderma, Novartis, PPM, Sanofi, SciRhom, Takeda, UCB, Zura Bio, Amgen, Bristol Myers Squibb, and Pfizer outside the submitted work; his departments have received grants from his participation as a clinical and research investigator for AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Brandenburg Medical School Theodor Fontane, the European Academy of Dermatology and Venereology, European Union, German Federal Ministry of Education and Research, GSK, Incyte, InflaRx, MSD, Novartis, Relaxera, Sanofi, and UCB; serving as president of the EHSF e.V., president of the Deutsches Register Morbus Adamantiades-Behçet e.V., board member of the International Society for Behçet’s Disease, coordinator of the ALLOCATE Skin group of the ERN Skin, and chair of the ARHS Task Force group of the European Academy of Dermatology and Venereology; serving as Editor of the EADV News; and he is co–copyright holder of International Hidradenitis Suppurativa Severity Score System on behalf of the EHSF e.V. Ms Villumsen reported grants from UCB outside the submitted work and is co–copyright holder of the Hidradenitis Suppurativa Quality of Life questionnaire (all fees are donated to research). Dr Alavi reported serving as a board member of the HS Foundation; grants from the National Institutes of Health, La Roche-Posay, and the HS Foundation; and serving as a consultant for AbbVie, Avalo, Boehringer Ingelheim, InflaRx, Incyte, LEO Pharma, Sanofi, Cantargia, Novartis, and UCB. Dr Hamzavi reported support paid to institution from Pfizer, Incyte, L’Oréal/La Roche-Posay, Merck, Avita, ChemoCentryx, Janssen, Clinuvel, ITN, and Teva Pharmaceuticals; personal fees from AbbVie, UCB, Boehringer Ingelheim, Galderma, Novartis, MyDerm Portal, Vimela, Henry Ford Hospital, and Almirall; and serving as a board member for the HS Foundation and co-chair of the Global Vitiligo Foundation. Prof Ingram reported personal fees from AbbVie, Boehringer Ingelheim, Cantargia, ChemoCentryx, Citryll, Engitix, Incyte, Insmed, Kymera Therapeutics, MoonLake, Novartis, UCB Pharma, UNION Therapeutics, and Viela Bio outside the submitted work; is co–copyright holder of the Hidradenitis Suppurativa Quality of Life questionnaire and Investigator Global Assessment and Patient Global Assessment instruments for hidradenitis suppurativa; institutional income from copyright of the Dermatology Life Quality Index and related instruments, with royalties paid; a stipend as immediate past Editor-in-Chief of the British Journal of Dermatology; and an authorship honorarium from UpToDate. Dr Naik reported personal fees from AbbVie, Medscape, Sonoma Biotherapeutics, UCB, and Novartis; shares in Radera; and serving as Associate Editor for JAMA Dermatology and vice president of the Hidradenitis Suppurativa Foundation. Dr Garg reported personal fees from AbbVie, Almirall, Boehringer Ingelheim, Engitix, Immunitas Therapeutics, Incyte, Insmed, Novartis, Pfizer, Sun Pharma, UCB, UNION Therapeutics, and Zura Bio outside the submitted work. No other disclosures were reported.

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