A New Era in Hidradenitis Suppurativa Care

Hidradenitis suppurativa (HS) historically has been very challenging to manage, but we now have more therapies in our treatment armamentarium than ever before to help relieve our patients’ suffering. HS does not need to be as devastating for patients as it once was.

Our expanding options include topicals, which this issue explores in depth. We also have an increasing number of medical therapeutics, including biologics and small molecule inhibitors. Just as importantly, we have procedural treatments that play a critical role in care. 

As dermatologists, we are uniquely well suited to take ownership of this condition. We are experts in managing chronic inflammatory skin diseases, and we are also experts in skin surgery. This dual expertise allows us to provide both the medical and surgical approaches needed to optimize treatment outcomes for our patients with HS. High-yield tips for surgical management of HS are included in this issue as well.

A key priority in approaching HS today is the importance of early intervention. We must ensure that patients are treated in a timely manner to help mitigate disease progression, improve quality of life as soon as possible, and restore daily functioning. This is especially important when patients present during adolescence. We need to recognize early manifestations of HS and feel comfortable intervening at that stage, so these pediatric patients do not go on to experience years of unchecked disease. This issue includes a comprehensive guide to approaching pediatric patients with HS, from diagnosis to intervention.

There is also a robust HS therapeutic pipeline. Numerous therapies in phase 1 through phase 3 development are advancing rapidly; this issue focuses particularly on those phase 3 treatments that are, hopefully, right on the horizon. These include medications with different mechanisms of action and varied modes of delivery, from topical to oral to injectable, and even bispecific therapies to block multiple immune pathways simultaneously.

Remarkable innovation is happening in HS. Ultimately, it comes down to this: we are now able to provide patients with a level of care that was not previously possible because so many new therapies are being unlocked. My hope is that, in time, patients with HS will come to our clinics and, regardless of their disease severity, we will feel confident that we can promptly control their inflammation, improve their symptoms, and restore their quality of life. 

— Jennifer L. Hsiao, MD

Guest Medical Editor