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Original Paper

Free Access

Hospitalisations with Hidradenitis Suppurativa: An Increasing Problem That Deserves Closer Attention

Santos J.V.a, b · Lisboa C.b-d · Lanna C.e · Costa-Pereira A.a, b · Freitas A.a, b

Author affiliations

aDepartment of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, bCenter for Health Technology and Services Research (CINTESIS), cDepartment of Microbiology, Faculty of Medicine, University of Porto, and dDepartment of Dermatovenereology, Centro Hospitalar S. João, Porto, Portugal; eFaculty of Medicine, University of Rome Tor Vergata, Rome, Italy

Corresponding Author

João Vasco Santos, MD

Alameda Prof. Hernâni Monteiro

PT-4200-319 Porto (Portugal)

E-Mail jvasco.santos@gmail.com

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Dermatology 2016;232:613-618

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Background/Aims: Hidradenitis suppurativa (HS), a chronic inflammatory skin disease of the hair follicle, can lead to scarring and disability. With an estimated European prevalence of 1%, few epidemiological studies of HS have been performed, and none focused on hospitalisations. We aimed to study the time trends of HS hospitalisations and to evaluate the demographic characteristics, hospital incidence rate, readmissions, length of stay, comorbidities and risk factors of hospitalised HS patients. Methods: We performed a retrospective observational study using a national administrative database in Portugal, with discharges between 2000 and 2014. All the inpatients aged 5 years or more with a diagnosis of HS were included. Variables analysed were age, sex, admission and discharge date, discharge outcome and diagnoses. Results: A total of 1,177 patients were hospitalised in this time period (48 were aged 18 years or younger) with a male-to-female ratio of 1:1.17. There was a hospital incidence rate of 0.83 patients with HS per 100,000 person-years (95% CI = 0.78-0.88). The age group with the highest incidence rate was 20-29 years among women and 40-49 years among men. We recorded an increasing trend in the number of new hospitalised patients and in the hospital incidence rate of HS. Tobacco was the most common comorbidity/risk factor. Eighty-three percent of our population underwent HS surgery. Conclusion: This hospital-based incidence study showed that admission for HS is increasing and that the majority of the HS inpatients were surgical cases. In the future, prospective studies will be important to assess risk factors for hospitalisations and complications.

© 2016 S. Karger AG, Basel


  1. Zouboulis CC, Desai N, Emtestam L, et al: European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol 2015;29:619-644.
  2. Saunte DM, Boer J, Stratigos A, et al: Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol 2015;173:1546-1549.
  3. Schrader AM, Deckers IE, van der Zee HH, et al: Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol 2014;71:460-467.
  4. Dufour DN, Emtestam L, Jemec GB: Hidradenitis suppurativa: a common and burdensome, yet under-recognised, inflammatory skin disease. Post Grad Med J 2014;90:216-221.
  5. Von Der Werth JM, Williams HC, Raeburn JA: The clinical genetics of hidradenitis suppurativa revisited. Br J Dermatol 2000;142:947-953.
  6. Gold DA, Reeder VJ, Mahan MG, Hamzavi IH: The prevalence of metabolic syndrome in patients with hidradenitis suppurativa. J Am Acad Dermatol 2014;70:699-703.
  7. Kohorst JJ, Kimball AD, Davis MDP: Systemic associations of hidradenitis suppurativa. J Am Acad Dermatol 2015;73:S27-S35.
  8. Wolkenstein P, Loundou A, Barrau K, Auquier P, Revuz J: Quality of life impairment in hidradenitis suppurativa: a study of 61 cases. J Am Acad Dermatol 2007;57:621-623.
  9. Esmann S, Jemec GBE: Psychosocial impact of hidradenitis suppurativa: a qualitative study. Acta Derm Venereol 2011;91:328-332.
  10. Ellis LZ: Hidradenitis suppurativa: surgical and other management techniques. Dermatol Surg 2012;38:517-536.
  11. Ingram JR, Woo PN, Chua SL, et al: Interventions for hidradenitis suppurativa: a Cochrane systematic review incorporating GRADE assessment of evidence quality. Br J Dermatol 2016;174:970-978.
  12. Revuz JE, Canoui-Poitrine F, Wolkenstein P, et al: Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol 2008;59:596-601.
  13. Jemec GB, Heidenheim M, Nielsen NH: The prevalence of hidradenitis suppurativa and its potential precursor lesions. J Am Acad Dermatol 1996;35:191-194.
  14. AHIMA: ICD-9-CM coding guidance for LTC facilities. Appendix B: reporting and sequencing diagnoses on the health record and UB-04 claim form. http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048120.hcsp?dDocName= bok1_048120 (accessed February 11, 2016).
  15. Quan H, Sundararajan V, Halfon P, et al: Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005;43:1130-1139.
  16. Liy-Wong C, Pope E, Lara-Corrales I: Hidradenitis suppurativa in the pediatric population. J Am Acad Dermatol 2015;73:S36-S41.
  17. Statistics Portugal: Annual estimates of the resident population. https://www.ine.pt/ (accessed April 1, 2016).
  18. Breslow NE, Day NE: Statistical methods in cancer research. Lyon, International Agency for Research on Cancer, World Health Organisation, 1987, vol II: The design of cohort studies.
  19. US Census Bureau: Census 2000. Population by age, race and Hispanic or Latino origin for the United States: 2000. https://www.census.gov/census2000/sumfile1.html (accessed April 1, 2016).
  20. Vazquez BG, Alikhan A, Weaver AL, et al: Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol 2013;133:97-103.
  21. Khalsa A, Liu G, Kirby JS: Increased utilization of emergency department and inpatient care by patients with hidradenitis suppurativa. J Am Acad Dermatol 2015;73:609-614.
  22. Canoui-Poitrine F, Revuz JE, Wolkenstein P, et al: Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. J Am Acad Dermatol 2009;61:51-57.
  23. Kirby JS, Miller JJ, Adams DR, et al: Health care utilization patterns and costs for patients with hidradenitis suppurativa. JAMA Dermatol 2014;150:937-944.
  24. McMillan K: Hidradenitis suppurativa: number of diagnosed patients, demographic characteristics, and treatment patterns in the United States. Am J Epidemiol 2014;179:1477-1483.
  25. Kim GE, Shlyankevich J, Kimball AB: The validity of the diagnostic code for hidradenitis suppurativa in an electronic database. Br J Dermatol 2014;171:338-342.
  26. Jemec GB: The symptomatology of hidradenitis suppurativa in women. Br J Dermatol 1988;119:345-350.
  27. Kromann CB, Deckers IE, Esmann S, et al: Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: a cross-sectional study. Br J Dermatol 2014;171:819-824.
  28. König A, Lehmann C, Rompel R, et al: Cigarette smoking as a triggering factor of hidradenitis suppurativa. Dermatology 1999;198:261-264.
  29. Crowley JJ, Mekkes JR, Zouboulis CC, et al: Association of hidradenitis suppurativa disease severity with increased risk for systemic comorbidities. Br J Dermatol 2014;171:1555-1609.
  30. Shlyankevich J, Chen AJ, Kim GE, et al: Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: a chart-verified case-control analysis. J Am Acad Dermatol 2014;71:1144-1150.
  31. Ferrer-Marín F, Amigo ML, Vicente V: Leukaemic transformation in patients with haematological disease receiving tumour necrosis factor inhibitors. Clin Drug Investig 2012;32:423-426.
  32. Palmer RA, Keefe M: Early-onset hidradenitis suppurativa. Clin Exp Dermatol 2001;26:501-503.
  33. Deckers IE, van der Zee HH, Boer J, et al: Correlation of early-onset hidradenitis suppurativa with stronger genetic susceptibility and more widespread involvement. J Am Acad Dermatol 2015;72:485-488.
  34. Scheinfeld N: Hidradenitis suppurativa in prepubescent and pubescent children. Clin Dermatol 2015;33:316-319.
  35. Freitas A, Silva-Costa T, Lopes F, et al: Factors influencing hospital high length of stay outliers. BMC Health Serv Res 2012;12:265.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 29, 2016
Accepted: July 18, 2016
Published online: September 30, 2016
Issue release date: January 2017

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 2

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: https://www.karger.com/DRM

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