Hidradenitis suppurativa may be underdiagnosed in males, study finds

Retrospective US claims data presented at the Fall Clinical Dermatology Conference suggest that hidradenitis suppurativa (HS) may be underdiagnosed in male patients. While formal ICD-10 diagnoses show a traditional 3:1 female predominance, an analysis of symptom-defined disease—based on recurrent claims for abscesses, furuncles, or pilonidal cysts—revealed more balanced prevalence between sexes.

Using the Komodo Health database, which covers over 300 million patients, researchers found that among those with symptom-defined disease, prevalence was 43 per 100,000 in males and 37 per 100,000 in 2017, shifting to 67 per 100,000 in males and 54 per 100,000 in 2024. This indicates that when symptoms are tracked without a formal diagnosis, males may actually show a slight predominance.

Additionally, a separate analysis within the study examined geographic disparities, finding that rural patients with HS are less likely to access dermatological care compared to those living in urban areas.