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August 5, 2019

Hidradenitis Suppurativa: the link between misdiagnosis and severe cases

Mistaken as a boil, infection or folliculitis, misdiagnosis in the early stages of Hidradenitis suppurativa leads to delays in diagnosis and treatment.

By GlobalData Healthcare

Characterised by boils and scarring on the skin, Hidradenitis suppurativa (HS) is a long-term, recurrent skin condition that causes painful lumps under the skin that form near hair follicles where sweat glands are present.

The signs and symptoms of HS are a mixture of red pea-sized boils, blackheads, cysts, scarring, and channels in the skin that may break open and leak pus or cause tunnels under the skin.

Mainly affecting areas are the underarm and pubic regions; HS usually develops between puberty and age 40.

Early detection is important for delaying the progression of the disease and associated scarring, as there is currently no cure.

The majority of HS cases in the seven major markets (7MM), including the U.S., France and the UK, present with mild or moderate symptoms; however, an important proportion of cases, approximately 25 per cent, are diagnosed as severe (Figure 1).

Figure 1 below provides an overview of the severity distribution of diagnosed active prevalent cases of HS in the 7MM.

GlobalData anticipates that the number of diagnosed active prevalent cases of HS will reach approximately 800,000 cases by 2028 in the 7MM, at an Annual Growth Rate (AGR) of 0.11 per cent.

Among the 7MM, the UK stands out with the highest proportion of severe cases with 30 per cent.

One possible explanation for a larger proportion in the UK is misdiagnosis at the early stages of the disease leading to delays in diagnosis and treatment. HS can initially be mistaken as a boil, infection, or folliculitis.

A major public health concern, HS contributes to long-term disability, income lost due to disability, and poor quality of life.

Patients may develop depression due to social isolation, pain, discomfort, and embarrassment from associated symptoms.

HS is commonly accompanied by one or more co-occurring diseases such as inflammatory bowel disease (IBD), and while mild cases of HS can be controlled with medication, persistent or severe HS may require surgery.

Future epidemiologic and medical research is crucial because the cause of HS is widely misunderstood.

Further research is needed to investigate the cause and prevalence of HS to gain insight into the frequency of disease, to find effective treatments, as well as to raise awareness.

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