What is hidradenitis suppurativa?
Hidradenitis suppurativa, commonly referred to as HS and also known as acne inversa, is a chronic, often progressive, systemic, inflammatory skin
condition that commonly manifests as subcutaneous nodules and abscesses in flexural sites, such as the groin or axillae.3,7 If left untreated,
HS may advance quickly.8,9 Timely intervention is needed to help prevent permanent damage.3
Hear from your peers about understanding HS
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The facts about HS
HS is widely under-recognized. This can cause diagnostic delays that can facilitate disease progression and long-lasting negative effects on
a patient's quality of life.10-12 The shame and embarrassment that may be associated with HS can be made worse by misconceptions about
its causes, but these can be corrected with education about the condition. Knowing fact from fiction about HS can help get patients the
accurate diagnosis and treatment they promptly need.9,11
-
In the United States,
approximately
1 in 100 people may have HS
and many go
undiagnosed4,13-15 -
The average time to
diagnosis is up to
10 years4 -
7 in 10
Patients
have moderate or severe HS by the time they receive a diagnosis9 -
Patients may see up to
10 Providers
before receiving an
accurate
diagnosis16,17
-
HS may lead to
depression, anxiety,
and loss of sexual
intimacy11,18,19 -
Patients can feel intense
shame and
embarrassment20 -
In one study, HS patients
reported the lowest
quality of life out of 35 skin disorders21
-
- Contagious22
- An infectious condition22
- A result of poor hygiene22
- A condition that only affects women, people with obesity, or people of African descent3,23
Hs is not
-
- A chronic, systemic, inflammatory condition3
- A condition that can affect people of all genders, races, and ethnicities who are from all walks of life24,25
- Treatable with early and effective intervention3,26,27
Hs is
FACT
Many patients first present with symptoms to a primary care
physician or non-HS-treating dermatologist. Recognizing the
condition is the first step in getting patients the individualized care they need.2
Early recognition
and intervention are
critical3
An HS diagnosis requires a physical and historical assessment. There are 3 essential diagnostic criteria for distinguishing HS28
Lesions11
One or more painful,
inflammatory,
deep-seated
nodules, abscesses, or
comedones.
Location11,28
Lesions are most common on
flexural
sites, like the axillae,
inframammary,
groin, perineal
and perianal regions.
They are
less common on ears, face,
scalp, back, chest, or legs.
Chronicity25,29
Recurrence at least twice within 6
months and/or persistence of at
least 3 months.
Ask your patients
Have you had
outbreaks
of boils
during the
last 6 months, and if
so,
where and how
many?
If yes, it
could be HS
Up to ~90% sensitivity in
evaluation30
If you
recognize, refer
Management and treatment strategies for HS should be led by an HS-treating
dermatology provider.2
Hidradenitis
suppurativa risk
factors and
comorbidities
Knowing some of the common risk factors and comorbidities associated with HS can help identify patients early on. Some risk factors
may also be comorbidities.31
RISK FACTORS3,4,7,11,14,31-33
- Female gender3x increased risk
- ObesityBMI ≥30 kg/m2
-
Family history~40% of
patients with HS have a family history of the condition
Evaluating family history could help increase the
likelihood of a timely diagnosis - African descent~2.5x more common vs Caucasians
- Active cigarette smoking Up to 9.4x higher risk
-
AgeOnset typically
occurs in people aged 20+ years
HS flares may be associated with hormonal changes (eg, puberty, menstruation, pregnancy, or menopause). It is important to evaluate each patient individually
BMI, body mass index.
Risk factors are not
limited only to those listed.
COMORBIDITIES3,7,31,33-35*
- ObesityPrevalence may be >75%
- Joint spondyloarthropathies Prevalence: 3.7%
- Squamous cell skin cancer Prevalence: 3% to 37%†
- Type 2 diabetes Prevalence: up to 30%
- Polycystic ovary syndrome Prevalence: >3-fold risk
- Substance-related disorder Prevalence: 4%
- Metabolic syndrome Prevalence: 40%
- Depression Prevalence: ~43%
*Comorbidities are not
limited only to those listed. Prevalence is reported as prevalence of comorbidities in patients with HS
based on different studies in the medical literature.
†Range based on anatomic distribution.
FACT
Given the numerous
comorbidities associated with
HS, management coordinated between a multidisciplinary
care team should be based on the individual.2
Learn more >
Help shine a light on HS
by
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on social
media today
Illuminate the facts about hidradenitis suppurativa
The following questions can serve as helpful reminders about HS. Swipe or click on the correct answers.
What generally characterizes HS disease progression?7
Moderate to severe psoriasis located in intimate body areas
SO CLOSE. Keep going
Recurrent, painful lesions often located in intimate body areas
CORRECT. Keep it up
Recurrent joint pain accompanied by painful skin lesions
SO CLOSE. Keep going
Generally, who is most impacted by HS?7
People with arthritis who are primarily Caucasian
SO CLOSE. Keep going
Females, people of African descent, and those with a lower socioeconomic status
CORRECT. Keep it up
Those who experience acute hair loss and joint pain
SO CLOSE. Keep going
On average, how long do people wait for an official HS diagnosis after first symptom onset?4
A few months
SO CLOSE. See how you did
About 10 years
CORRECT. Keep it up
About 2 years
SO CLOSE. See how you did
SO CLOSE
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Try again or learn more to help bring HS out of the shadows.
What would you like to explore next?
GOOD JOB
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What would you like to explore next?
Learn how to identify and diagnose HS early to
shed light on improved outcomes
Help raise awareness about HS today
References: 1. Chiricozzi A et al. J Eur Acad Dermatol Venereol. 2019;33(suppl 6):15-20. 2. Collier EK et al. Int J Dermatol. 2020;59(6):744-747. 3. Sabat R et al. Nat Rev Dis Primers. 2020;6(1):18. 4. Garg A et al. J Am Acad Dermatol. 2020;82(2):366-376. 5. Daxhelet M et al. Dermatology. 2020;236(5):431-438. 6. Alavi A et al. J Cutan Med Surg. 2017;21(6):513-524. 7. Alikhan A et al. J Am Acad Dermatol. 2019;81(1):76-90. 8. van der Zee HH et al. Br J Dermatol. 2022;186(2):355-356. 9. Ingram JR et al. J Eur Acad Dermatol Venereol. 2022;36(9):1597-1605. 10. Dufour DN. Postgrad Med J. 2014;90(1062):216-220. 11. Kimball AB et al, eds. Hidradenitis Suppurativa: A Disease Primer. Adis; 2017. 12. Kokolakis G et al. Dermatology. 2020;236(5):421-430. 13. Revuz JE et al. J Am Acad Dermatol. 2008;59(4):596-601. 14. Deckers IE et al. Curr Derm Rep. 2014;3(1):54-60. 15. Micheletti RG. Semin Cutan Med Surg. 2014;33(suppl 3):S48-S50. 16. Shah M et al. J Clin Cosmet Dermatol. 2020;4(2):1-4. 17. Loget J et al. Ann Dermatol Venereol. 2018;145(5):331-338. 18. Machado MO et al. JAMA Dermatol. 2019;155(8):939-945. 19. Alavi A et al. Int J Womens Dermatol. 2018;4(2):74-79. 20. Tzellos T et al. Dermatol Ther (Heidelb). 2020;10(1):63-71. 21. Balieva F et al. Br J Dermatol. 2017;176(5):1170-1178. 22. Ather S et al. Int Wound J. 2006;3(3):159-169. 23. Garg A et al. JAMA Dermatol. 2017;153(8):760-764. 24. Prens EP et al. Am J Clin Dermatol. 2020;21(4):579-590. 25. Zouboulis CC et al. Exp Dermatol. 2021;30(suppl 1):27-30. 26. Shih T et al. Am J Clin Dermatol. 2022;23(6):749-753. 27. Paek SY et al. J Am Acad Dermatol. 2017;76(4):772-773. 28. Revuz J. J Eur Acad Dermatol Venereol. 2009;23(9):985-998. 29. Saunte DML et al. JAMA. 2017;318(20):2019-2032. 30. Vinding GR et al. Br J Dermatol. 2014;170(4):884-889. 31. Miller IM et al. Dermatol Clin. 2016;34(1):7-16. 32. Kohorst JJ et al. J Am Acad Dermatol. 2015;73(5 suppl 1):S27-S35. 33. Goldburg SR et al. J Am Acad Dermatol. 2020;82(5):1045-1058. 34. Phan K et al. Ann Transl Med. 2020;8(13):821. 35. Vazquez BG et al. J Invest Dermatol. 2013;133(1):97-103.
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