Prevalence of Hidradenitis Suppurativa in Skopje, North Macedonia.

Introduction: Hidradenitis suppurativa (HS) exhibits varying prevalence globally, markedly influenced by geographical and ethnic distinctions. This study, part of the Global Hidradenitis Suppurativa Atlas (GHiSA) initiative, aimed to assess the prevalence of HS in North Macedonia and contribute to the global epidemiology of this complex dermatological disorder.

Methods: Conducted at City General Hospital "8th September" in Skopje, North Macedonia, from March 23, 2023, to May 30, 2023, this single-center study enrolled 597 healthy adults using a validated screening questionnaire. The participants were selected from accompanied outpatients and visitors of hospitalized patients in various departments, excluding the dermatology department. The questionnaire consisted of questions leading to the diagnosis of HS, particularly about the presence of boils, and it was administered as an interview by dermatology residents under the supervision of dermatologists. Participants who tested positive on the screening questionnaire were examined by dermatologists.

Results: Out of 600 participants, 597 successfully completed the questionnaire (291 male and 301 female), and among them, 5 individuals (3 male and 2 female) were identified as having HS. This indicates an HS prevalence rate of 0.84%. Demographic analysis showed a male predominance in the HS group, with a median age of onset at 36 years (42.0 in the control group). Smoking and higher BMI were associated with HS. Notably, the study identified HS cases among participants initially screening negative, emphasizing the complexity of diagnosis. The diagnostic questionnaire demonstrated a sensitivity of 0.60 and a specificity of 0.84.

Conclusion: This epidemiological study contributes to the global understanding of HS prevalence, demographic characteristics, and associated factors. With a rate of 0.84%, HS remains a significant concern. The observed male predominance in HS incidence deviates from global trends.