Characterizing hidradenitis suppurativa in Malaysia

28 Sep 2018

In Malaysia, hidradenitis suppurativa (HS) has a male preponderance, occurring at an early age with greater disease severity, as reported in a recent study.

Researchers looked at 62 HS patients (mean age 29.2 years) seeking treatment at three tertiary hospitals in Northern Peninsular Malaysia. The majority (83.9 percent) were male, and the median age at disease onset was 18 years. Diagnosis was delayed by a median of 3 years.

A total of 29 patients were smokers with a median of 5 pack-years, all of which were men. Positive family history was identified in about 25 percent of patients overall.

Most patients presented with papular lesions (91.9 percent). Other commonly observed lesion types were nodules (80.6 percent), scars (75.8 percent) and abscesses (54.8 percent). There was a high percentage of axillary involvement (90.3 percent), followed by gluteal (62.9 percent) and inguinofemoral (56.5 percent). Involvement was also found in atypical sites such as pre/postauricular (33.9 percent), nape (24.2 percent), back (19.4 percent), thigh (8.1 percent) and below the knee (3.2 percent).

Only 12 patients had metabolic syndrome, although close to three-quarters of the cohort were overweight or obese. Moreover, 43.5 percent had abdominal obesity. On multiple logistic regression, HS was associated with an increased risk of low high-density lipoprotein cholesterol (odds ratio [OR], 2.8) and obesity (OR, 2.7).

Based on Hurley staging, HS was stage I in 24.2 percent of patients, stage II in 61.3 percent and stage III in 14.5 percent. Sonographic scoring, on the other hand, showed that 50 percent had severe disease and 56.9 percent had subclinical lesions. Agreement between ultrasonography and Hurley staging of disease severity was fair (p=0.004).

Ultrasonography detected a significant number of subclinical lesions (56.9 percent) and allowed better assessment in terms of disease severity, researchers noted.

Due to the relatively small sample size, the present data may not reflect the true demographic pattern of HS population in Northern Malaysia, they added. A community-based study is required to reveal the true picture.

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