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The true prevalence of hidradenitis suppurativa (HS) is challenging to estimate because it is often under diagnosed and misdiagnosed; the incidence seems to be increasing.
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HS is associated with a wide range of somatic comorbidities, from metabolic syndrome to rheumatologic conditions, as well as psychological comorbidities.
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The sum of somatic and psychological comorbidities places significant burden on HS patients beyond dermatologic symptoms.
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Treatment of HS needs to target dermatologic symptoms
Prevalence, Risk Factors, and Comorbidities of Hidradenitis Suppurativa
Section snippets
Key points
Prevalence and incidence
As hidradenitis suppurativa (HS) has been an orphan disease for decades and subsequently a highly misdianogsed and underdiagnosed condition with a significant diagnose delay,1, 2 the true prevalence has been correspondingly challenging to estimate. Prevalences are reported as low as 0.00033% and as high as 4.1%.3, 4, 5, 6, 7, 8
Prevalence estimates seem to fluctuate according to the nature of the study design, participants, and geography. A uniform pattern based on these methodologic differences
Risk factors and comorbidities
There is a considerable overlap between what are characterized risk factors and comorbidities. One possible definition of a risk factor is something that increases a person's chances of developing a disease, whereas a comorbidity may be defined as a coexisting medical condition or disease process, and may be categorized as psychological or somatic.
Psychological comorbidities
Because the skin is a visible and a communicative organ, having a skin disease may subsequently advocate psychological comorbidities. Quality of life, which is a broad term, has been found to be impaired in HS in an even greater extent than diseases like psoriasis, acne, neoplasms, strokes, or even heart transplant candidates when investigated by general quality of life questionnaires such as EuroQol-5D and dermatology-specific questionnaires such as Dermatology Life Quality Index.29, 104, 105
Summary
The true prevalence of HS is challenging to estimate because it is strikingly misdiagnosed and underdiagnosed. HS is associated with a number of somatic as well as psychological comorbidities that burden the HS patients beyond their skin symptoms. When treating HS patients, it is imperative to address the screening and treatment of possible comorbidities in addition to the skin symptoms.
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