Hidradenitis Suppurativa Prevalence in Indonesia: A Cross-Sectional Multicenter Study and Validation of a Screening...

Introduction: Studies on the prevalence of hidradenitis suppurative (HS) in Southeast Asia are scarce, and no studies have been conducted in Indonesia. This study aimed to calculate the prevalence of HS in Indonesia and validate this questionnaire in our population as part of the Global Hidradenitis Suppurativa Atlas (GHiSA) initiative.

This multicenter cross-sectional study was conducted at 7 teaching hospitals in western and central Indonesia from December 2022 to June 2023. A total of 3,237 healthy adults accompanying patients in the outpatient clinics consented to participate. Physicians or nurses delivered the validated screening questionnaire, and photos of the axilla and groin were taken from screen-positive individuals and 10% of the screen-negative individuals. The dermatologist examined the clinical photos to confirm the diagnosis of HS.

The prevalence of HS in our study population was 0.43% (14/3,237; with 95% confidence interval [CI]: 0.26%-0.72%), and there was no significant difference in gender, age, body mass index (BMI), and smoking habit between the HS and non-HS groups. In the HS group, males and females were equally affected, with the median age being 29 years with interquartile range (IQR: 24.8-38.5), median BMI of 23.0 (IQR: 21.1-26.4), and 28.6% being smokers. The screening questionnaire showed a sensitivity of 0.43 (6/14; 95% CI: 0.18-0.17), specificity of 0.94 (362/386; 95% CI: 0.91-0.96), positive predictive value of 0.20 (6/30; 95% CI: 0.08-0.39), and negative predictive value of 0.98 (362/370; 95% CI: 0.96-0.99).

The prevalence of HS in Indonesia is 0.43%, slightly lower than those reported in other Southeast Asian countries. Age, gender, BMI, and smoking habits were not risk factors for HS in our population. The questionnaire is moderately accurate for screening HS but remains valuable in detecting around 50% of undiagnosed cases.