Hidradenitis Suppurativa in Skin of Colour: A Multicentre Review of Clinical and Demographic Trends in Nigeria

Hidradenititis suppurativa in Nigeria

Abstract

Abstract
Background: Hidradenitis suppurativa (HS) is underreported in African populations, leading to gaps in clinical
and epidemiological data. This study aimed to describe the clinical characteristics and associated
comorbidities among Nigerian patients.
Methods: This retrospective chart review included 64 adult patients diagnosed with HS between January
2017 and December 2022 across seven dermatology clinics in Nigeria. Data extracted included demographic
characteristics, disease severity (Hurley staging), body mass index (BMI), and medical history (smoking,
alcohol use, diabetes, acne). BMI was categorized according to WHO cutoffs, and statistical analysis was
performed using SPSS version 26; p < 0.05 was considered significant.
Results: Among the 64 patients, 70.3% (n=45) were female. The median age was 30 years [IQR: 24,36], and
HS onset occurred before age 29 in 66.9%. The axilla was the most commonly affected site, with inflammatory
nodules (64%), papules (45.3%), and pustules (34.4%) as predominant lesion types. Over half (56.2%) had
moderate to severe disease (Hurley Stage II/III). Obesity (BMI > 25 Kg/m²) was present in 51.5%, while acne
(29.7%) and diabetes (4.7%) were the most frequent comorbidities. Antibiotics were the primary treatment
modality.
Conclusion: Although HS appears uncommon among Nigerians, severe disease is the most common
presentation. The axilla is the predominant site of involvement, nodules and papules are the most common
lesion types. Treatment is mostly with antibiotics. This study underscores the need for increased awareness,
earlier diagnosis, and expanded therapeutic options, including biologics, in African populations.
Keywords: Hidradenitis suppurativa, clinical, Hurley's stage, Africa