Practical Guidelines for Managing Patients With Hidradenitis Suppurativa: An Update

Abstract

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that is characterized by the formation of comedones, papules, nodules, abscesses and sinus tracts in the axillary, inframammary, groin, and gluteal areas. Up to 3.8% of the Canadian population has HS, though due to a lack of awareness of HS, many patients are initially misdiagnosed and do not receive adequate treatment early on in the disease course. Once a diagnosis of HS is made, developing an effective management plan can be a dilemma for many providers. There is significant variability in response to any given therapy within the HS patient population and many HS patients have other medical comorbidities which must be taken into consideration. The aim of this review is to provide a practical approach for all healthcare providers to diagnose and manage HS and its associated comorbidities. A sample electronic medical record template for HS management was developed by the Canadian Hidradenitis Suppurativa Foundation Executive Board and is intended for use in clinical settings. This will help to increase collaboration between primary healthcare providers, dermatologists, and other medical specialists and ultimately improve the quality of care that HS patients receive.

Biologic drugs in hidradenitis suppurativa: what does the GP have to know? A narrative review

“…It is recommended only for acute abscesses for pain relief ( 42 ). For extensive Hurley Stage III HS, wide local surgery or carbon dioxide laser excision may be necessary to achieve disease control ( 44 ). …”

“…For extensive Hurley Stage III HS, wide local surgery or carbon dioxide laser excision may be necessary to achieve disease control ( 44 ).…”

Management of Hidradenitis Suppurativa Using Janus Kinase Inhibitors: An Evidence-Based Review

“…Similarly, this may substantiate the lack of effective therapies for HS disease control as indicated by recent guidelines. 3 Preliminary clinical trial results evaluating povorcitinib and upadacitinib use demonstrated 45.9% and 38.3% of patients achieving HiSCR50 respectively. 4,5 These findings are in keeping with our review.…”

The Evolving Hidradenitis Suppurativa Treatment Landscape: Learning Gaps Among Canadian Dermatologists

“…Current challenges in the management of HS were consistent irrespective of HS patient load, with the greatest knowledge gaps related to surgical management, pharmacologic and non-pharmacologic strategies, and practical aspects of care. There is an appetite for learning about evolving HS management strategies and with new treatments on the horizon and recently published practical guidelines, 5 we are hopeful that dermatologists’ knowledge base will increase. There is also an opportunity for raising awareness about HS and for collaborations between dermatologists, rheumatologists, surgeons, urgent care clinics, general practitioners, industry partners, and HS patient organizations to develop resources to support improved patient outcomes and satisfaction.…”

“…1 Indeed, there is growing excitement for new targeted agents 2 to treat HS that are in late phases of clinical development and regulatory submission. Although a multidisciplinary approach is recommended, [3][4][5] dermatologists are often the quarterbacks for managing this complex disease. The last targeted HS biologic treatment to be approved in Canada was Humira (adalimumab) more than 7 years ago.…”