Research Shows Lower SES Linked With HS in French Adults


Lower socioeconomic status (SES) was not linked with hidradenitis suppurativa (HS) in minors, but was associated with obesity and tobacco use in this age group.

There is a significant association between a lower socioeconomic status (SES) and hidradenitis suppurativa (HS) in the adult population, results of a cross-sectional study show.

In addition, low SES is linked with obesity and tobacco consumption among children aged 7 to 17 years, although not with HS, according to an analysis of matched populations.

Findings were published in Journal of the European Academy of Dermatology and Venereology.

HS affects 1% to 2% of the world’s population, while previous research shows the condition has a negative impact on patients’ social, professional, and sexual lives. In addition, although a lower SES has been reported in patients with HS, limitations in available studies preclude researchers from drawing definitive conclusions, the investigators explained.

To address this knowledge gap, they assessed the SES of patients using a specific SES indicator, the French DEPrivation index (FDep). The FDep “is a multidimensional, area-based index that measures socioeconomic differences using 4 census-derived variables with 2 positive and 2 negative dimensions: the median income per household, the high school graduation rate in the population aged 15 years or older, the unemployment rate in the labor force, and the rate of blue-collar workers in the labor force,” the authors wrote.

They compared those hospitalized with HS with the general hospitalized population who did not have HS. Patients were aged 7 to 75 years and had at least 1 hospital stay between 2014 and 2021. All controls had at least 1 stay between 2016 and 2021 and had no diagnosis or history of diagnosis of HS.

A total of 33,880 patients with HS and 24,445,337 patients without HS were included in the analysis.

“After propensity score matching, logistic regression showed a significant association between HS and social disadvantage,” authors wrote.

Additional findings included the following:

  • A 22.5% increased risk of developing HS for individuals being in FDep quintile 5 (the most disadvantaged quintile) vs quintile 1 (the least disadvantaged quintile) (P < .0001)
  • Logistic regression showed no association between HS and social disadvantage in the subgroup aged 7 to17 years
  • In this minor population, an association between HS and social disadvantage was observed when propensity score matching was performed on age and sex only
  • In the 7-to-17-years population, tobacco consumption and obesity were observed in 1.9% and 6.4% of the HS population, respectively, vs 0.4% and 1% in the controls (P < .0001 for both)

On average, those in the HS group were younger and more likely to smoke and be obese.

Results suggest a relationship between poor social status, tobacco consumption, obesity, and HS, authors said, while several previous studies have pointed to the potential role of diet and tobacco in the development of the condition.

However, low SES is also a well-known risk factor for obesity and tobacco consumption, they added.

“In children, HS by itself is not linked to low SES, but it is associated with these 2 important risk factors. These results emphasize the critical need of fighting against smoking and obesity in children,” authors stressed.

In genetically predisposed individuals, early efforts made to combat these 2 risk factors could be beneficial to reduce the risk of HS.

Data also showed cardiovascular comorbidities, psychological disturbances, pilonidal sinus, spondyloarthropathies, and irritable bowel syndrome are all significantly higher among patients with HS compared with controls.

“With the demonstrated impact of HS on the quality of life, and the increased risk of comorbidities that we confirmed in the present study, it is crucial to promote early detection of HS and to provide the proper care to the patients, but also to detect and to treat the associated comorbidities,” the authors concluded.


Bulsei J, Fontas E, Passeron T. Hidradenitis suppurativa and social disadvantage: A nationwide administrative data study of the French hospitalized population. J Eur Acad Dermatol Venereol. Published online May 5, 2023. doi:10.1111/jdv.19159

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