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Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of
J R Ingram1, S Jenkins-Jones2, D W Knipe3
1Department of Dermatology & Academic Wound Healing, Division of Infection and Immunity, Cardiff University, Cardiff, CF14 4XN, U.K.
The British Journal of Dermatology
|November 3, 2017
Summary
Hidradenitis suppurativa (HS) is more common than previously thought, affecting 0.77% of the UK population. A significant portion of HS cases remain undiagnosed, highlighting a need for improved recognition and diagnosis.
Area of Science:
- Dermatology
- Epidemiology
- Public Health
Background:
- Epidemiological data for hidradenitis suppurativa (HS) show significant variability, with prevalence estimates ranging from 0.05% to 4%.
- Previous population-based studies may have underestimated HS prevalence due to undiagnosed cases.
Purpose of the Study:
- To investigate the hypothesis that true HS prevalence is higher than reported in prior population-based studies.
- To determine the prevalence of HS in the UK population using a robust methodology.
Main Methods:
- A population-based observational and case-control study was conducted using the UK Clinical Practice Research Datalink (CPRD) and hospital episode statistics.
- Physician-diagnosed HS cases were identified via Read codes; unrecognized 'proxy' cases were identified using algorithms and validated through GP questionnaires.
- A case-control analysis was performed to identify associations with HS.
Main Results:
- The point prevalence of HS in the UK was found to be 0.77% (95% CI 0.76-0.78%), with approximately one-third of cases being previously unrecognized.
- Including probable cases, the overall HS prevalence increased to 1.19%.
- Significant associations were found between HS and current smoking (OR 3.61), obesity (OR 3.29), type 2 diabetes, Crohn disease, hyperlipidaemia, acne, and depression.
Conclusions:
- Contrary to previous estimates, hidradenitis suppurativa is a relatively common condition in the UK, with a prevalence of 0.77%.
- A substantial proportion of HS cases (one-third) were unrecognized, indicating underdiagnosis.
- The study highlights the need for increased awareness and improved diagnostic strategies for HS.
