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 Hi
dradenitis Suppurativa Atlas (GHiSA) initiative, aimed to
assess the prevalence of HS in North Macedonia and con
tribute to the global epidemiology of this complex der
matological 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 ac
companied outpatients and visitors of hospitalized patients
in various departments, excluding the dermatology de
Received: January 24, 2024
Accepted: April 25, 2024
Published online: July 7, 2025
partment. 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 derma
tology residents under the supervision of dermatologists.
Participants who tested positive on the screening ques
tionnaire were examined by dermatologists. Results: Out of
600 participants, 597 successfully completed the ques
tionnaire (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%. Demo
graphic 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 pre
dominance in HS incidence deviates from global trends.