Prevalence of Hidradenitis Suppurativa in Serbia: Validation of a Screening Questionnaire.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful nodules and rupturing abscesses causing sinus tunnels and scarring, most commonly in the axilla, inguinal, perianal, and submammary areas. The global prevalence varies considerably, ranging from 0.00033% to 4.1%. To date, no epidemiological studies on HS have been conducted in Serbia. The aim of the study was to determine the prevalence of HS in Serbia.

Methods: This research is a monocentric study initiated by the Global Hidradenitis Suppurativa Atlas (GHISA), conducted at the Military Medical Academy in Belgrade, and is part of the GHISA project. The study included healthy companions of the patients who filled out a validated questionnaire in the local language in which they reported their gender, age, weight, height, cigarette consumption, and the presence of painful nodules on the skin of the body folds. All people who reported having the changes defined in the questionnaire and every tenth person who said there were no changes were examined by experienced dermatologists and final year dermatology residents.

Results: In the study, among 490 respondents, 4 were confirmed as HS, the point prevalence was 0.82%. HS was diagnosed equally in women and men. All patients had a BMI above normal, which is a known risk factor for HS. The affected regions in the HS group were the axilla and groin. The screening questionnaire had a sensitivity of 0.5 (2/4), a specificity of 0.93 (62/67), a positive predictive value of 0.29 (2/7), and a negative predictive value of 0.97 (62/64).

Conclusion: The prevalence of HS in Belgrade, Serbia is 0.82%. The disease occurs equally frequently in both sexes. The HS screening questionnaire proves to be an appropriate instrument for population surveys.