Skin condition prevalence high, awareness low

Thursday, 17 January, 2019

A new Australian prevalence study¹ of hidradenitis suppurativa (HS) estimates a very high number of Australians have the devastating skin condition.

The study, published in PLOS ONE, also suggests not all clinicians are familiar with the disease, resulting in delays to diagnosis for many Australians.¹

HS is a chronic skin condition characterised by inflamed areas typically located around the armpits and groin.^2,3 Also known in the past as ‘acne inversa’, HS can take on a variety of forms which can differ from person to person. HS can occur at any age, but the condition most commonly develops in adults in their early 20s.³

Based on face-to-face household interviews of a large (n=11,433) representative sample of the adult Australian population using a previously validated HS screening questionnaire, the robust and rigorous study estimates the prevalence of HS is 0.67% (approximately 165,000 Australians, based on a total Australian population of 25 million people⁵).¹

In the study, 88 individuals were identified as potentially having HS. But only 6 (6.8%) had been previously diagnosed with HS.¹ Many diagnosed and undiagnosed individuals had seen several clinicians/specialists regarding their condition.¹

A quarter of the undiagnosed individuals suspected of having HS had not seen any clinician regarding their boils.¹ In addition, many diagnosed and undiagnosed individuals had seen several clinicians/specialists regarding their condition.¹ Therefore, the study speculates that the low diagnosis rate may result from a combination of factors, including:

decentralisation of care,
lack of familiarity of some clinicians with the disease, and
many patients not seeking medical help for single or infrequently recurring boils.¹ The study’s conclusion indicates a need to increase awareness of the disease in Australia among both the broader medical community and the general population.¹

Due to the severe impact that HS has on patients, this study is particularly important to understand the prevalence and diagnosis rates of HS in Australia, as well as the profile and characteristics of people living with HS and their management pathways. In a wide range of countries, the mean time between symptom onset and HS diagnosis is 7.2 years,⁴ which further illustrates why greater awareness and understanding of the condition is needed among healthcare professionals.

Key findings:

Estimated prevalence of HS in Australia = 0.67% (or approx. 165,000 Australians)
Current diagnosis rate of suspected HS cases = 6.8%
96.7% of undiagnosed individuals had previously talked to a GP about their condition
Individuals suspected of having HS were more likely to be female, young and obese

References

Calao, M., Wilson, J., Spelman, L., Billot, L., Rubel, D., Watts, A. and Jemec, G. Hidradenitis Suppurativa (HS) prevalence, demographics and management pathways in Australia: A population-based cross-sectional study. PLOS ONE. 2018; 13(7)
Mayo Health Clinic. Hidradenitis Suppurativa. Available at: http://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/home/ovc-20200012. Accessed May 2018
Jemec G. Hidradenitis Suppurativa. N Engl J Med. 2012; 366:158-64
Saunte DM, Boer J, Stratigos A, Szepietowski JC, Hamzavi I, Kim KH, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol. 2015; 173(6):1546–9
Australian Bureau of Statistics. Population Clock. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/Web+Pages/Population+Clock?opendocument

Image credit: ©stock.adobe.com/au/yuriyzhuravov