Epidemiology of hidradenitis suppurativa in a large institutional 15-year retrospective study

Background Hidradenitis suppurativa (HS) is a chronic inflammatory disorder associated with substantial morbidity, yet large real-world studies evaluating prevalence and comorbidity patterns within single healthcare systems remain limited.Methods We retrospectively reviewed adult patients diagnosed with HS across an institution-wide cohort from September 2010 through October 2025. Demographics, anxiety, depression, acne history, and median income category by zip code were analyzed.Results Among 1,882,631 patients, 15,275 had HS, corresponding to a prevalence of 0.81%. Women represented 77.8% of cases, and the highest prevalence occurred among patients aged 31 to 40 years. HS patients were more than twice as likely to have acne compared with non-HS patients (odds ratio = 2.16; 95% confidence interval, 2.09–2.23; P < 0.001). Anxiety or depression was documented in 26.9% of patients. Median household income was not significantly associated with HS.Conclusion These findings reinforce the demographic and psychosocial burden associated with HS and may assist clinicians in earlier recognition and management.