Questionnaire-Based Global Prevalence of Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis

Background: Hidradenitis suppurativa (HS), a chronic inflammatory skin disease affecting intertriginous areas, presents a recurring and debilitating challenge. Even though recent efforts have been made to estimate the overall HS prevalence, variations in screening modalities and missing data from the Global South warrant further investigation. Understanding the HS prevalence is crucial for treatment approaches and pathogenesis. Thus, we aimed to estimate a global HS prevalence based on studies using homogeneous validated questions.

Methods: This systematic review was prospectively registered on PROSPERO and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Searches in PubMed, Embase, and CINAHL were performed on August 9, 2023. Original reports assessing the HS prevalence in adults using the following two questions were included: "Do you have recurrent boils of the skin?" and "Have you for the past 6 months had 2 or more boils/abscesses in any of the below locations: in the axilla, in the groin, around your genitals, on the buttocks, several locations i.e., first the buttocks then the axilla, etc.?" A pooled prevalence with 95% confidence interval (CI) was calculated with a random-effects model.

Results: Eight studies qualified for inclusion, of which the prevalence estimate ranged from 0.7% to 6.4%. The meta-analysis encompassing 49,971 participants revealed a global HS prevalence of 2.5% (95% CI, 1.8-3.5%).

Conclusion: This meta-analysis suggests a global HS prevalence of 2.5% using a validated questionnaire. Due to heterogeneity and sparse data from the Global South, this estimate should be interpreted with caution.