{
  "schemaVersion": 2,
  "eyebrow": "Dermatology",
  "title": "Hidradenitis Suppurativa",
  "summary": "Manage hidradenitis suppurativa by separating active inflammatory lesions from irreversible tunnels and scarring, documenting severity, addressing comorbid disease, and pairing systemic anti-inflammatory therapy with lesion-directed surgery when destructive disease persists.",
  "seoDescription": "Point-of-care management of hidradenitis suppurativa: staging, comorbidity assessment, biologic selection, antibiotics, and surgical integration.",
  "clinicalQuestion": "How should physicians stage, medically treat, and surgically manage hidradenitis suppurativa across inflammatory and destructive disease phases?",
  "specialty": "Dermatology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "hidradenitis suppurativa",
    "acne inversa",
    "adalimumab",
    "secukinumab",
    "bimekizumab",
    "Hurley stage",
    "HS surgery"
  ],
  "keyTakeaways": [
    "Treat active nodules and abscesses as inflammatory disease, but refer persistent draining tunnels, fibrosis, and scarred anatomic units for procedural planning because medical therapy cannot reverse established structural damage. [18][22]",
    "Document both Hurley stage and inflammatory lesion burden; Hurley staging is rapid and particularly reliable for identifying the most involved stage III disease, but it was originally designed to identify surgical candidates rather than to measure short-term change. [7][12]",
    "For U.S. moderate-to-severe HS, adalimumab, secukinumab, and bimekizumab are FDA-approved systemic options; adalimumab has an approved adult loading regimen followed by weekly or every-other-week maintenance dosing. [1][18][23]",
    "Do not repeatedly manage chronic HS lesions as isolated infections: incision and drainage often recurs, whereas destructive disease requires a lesion-directed surgical strategy integrated with inflammation control. [20][18]",
    "Screen actively for metabolic syndrome and inflammatory bowel disease when the clinical history or examination suggests either condition, because both are associated with HS. [8][9]"
  ],
  "sections": [
    {
      "id": "confirm-and-phenotype",
      "eyebrow": "Initial assessment",
      "heading": "Confirm HS and separate inflammatory activity from permanent damage",
      "intro": "The first management decision is whether a symptomatic site is medically reversible, surgically remediable, or both.",
      "paragraphs": [
        "Confirm the characteristic distribution of recurrent deep nodules, abscesses, draining tunnels, and scarring in axillary, inguinal, genitoanal, or inframammary skin. A solitary acute lesion without a recurrent intertriginous pattern should prompt reassessment for an alternative local process rather than automatic labeling as HS. [18][20]",
        "At each baseline and escalation visit, record anatomic regions involved; counts of abscesses and inflammatory nodules; draining tunnels; pain; drainage; and the dominant morphology at each site. This distinguishes an inflammatory phase, in which drug therapy is emphasized, from destructive disease with tunnels and fibrosis, in which combined medical-surgical treatment is generally required, and a burnout phase in which surgery may be the principal intervention. [18]",
        "Assign Hurley stage to the most involved area to communicate structural burden and surgical candidacy. Use it alongside a dynamic lesion measure such as IHS4 or total inflammatory lesion count when judging treatment response, because Hurley staging was developed for surgical stratification and is most dependable for the most involved stage III disease. [7][10][12]"
      ],
      "bullets": [
        "Ask specifically about prior incision and drainage, prior excision, lesion recurrence at the same site, and chronic drainage; recurrent drainage from a fixed site supports tunnel disease and should trigger surgical assessment rather than serial drainage procedures. [20][18]",
        "Document smoking, BMI, mechanical friction, age at onset, and family history; higher BMI, smoking, and mechanical stress are recognized risk factors, and early-onset disease may be more familial. [22]",
        "Ask about menstrual association when relevant; cyclical premenstrual flares support considering a hormonal contribution during treatment selection. [20]"
      ],
      "subsections": [],
      "table": {
        "caption": "Morphology-driven treatment direction in hidradenitis suppurativa. [18][20][22]",
        "columns": [
          "Dominant finding",
          "Interpretation",
          "Next management direction"
        ],
        "rows": [
          [
            "Painful inflammatory nodules or abscesses without established fibrosis",
            "Predominantly active inflammatory phase. [18]",
            "Use medical anti-inflammatory treatment; select topical, systemic, or biologic therapy according to extent and severity. [1][18]"
          ],
          [
            "Draining tunnels, fixed fibrosis, and morbid scarring",
            "Destructive disease with irreversible structural damage. [18][22]",
            "Coordinate inflammation control with lesion-directed surgical planning; medication may control symptoms but cannot remove established fibrosis. [18][22]"
          ],
          [
            "Previously drained lesion recurring at the same site",
            "Incision and drainage alone has a high recurrence problem in HS. [20]",
            "Reassess for persistent tunnel disease and refer for definitive procedural management rather than relying on serial incision and drainage. [20][18]"
          ]
        ]
      }
    },
    {
      "id": "comorbidity-and-risk",
      "eyebrow": "Systemic assessment",
      "heading": "Identify comorbid disease before choosing long-term therapy",
      "intro": "HS management should include targeted evaluation for systemic disease that changes drug choice, risk counseling, or referral.",
      "paragraphs": [
        "Assess for metabolic syndrome at diagnosis and during longitudinal care, particularly in patients with obesity or other cardiometabolic risk factors. HS is associated with metabolic syndrome; identify hypertension, dysglycemia, dyslipidemia, and central adiposity using the clinician's usual primary-care or cardiometabolic framework, then treat each abnormality directly rather than considering weight alone as the only modifiable issue. [8]",
        "Elicit chronic diarrhea, abdominal pain, hematochezia, weight loss, and perianal symptoms. HS is associated with inflammatory bowel disease, so compatible gastrointestinal symptoms should prompt evaluation for Crohn disease or ulcerative colitis and coordination with gastroenterology before selecting or changing systemic immune-directed therapy. [9]",
        "Before adalimumab, apply the product-label infection assessment, including evaluation for active tuberculosis and latent tuberculosis infection. The adalimumab label carries a boxed warning for serious infections, including active TB and reactivation of latent TB; defer initiation when clinically significant infection requires treatment. [1]"
      ],
      "bullets": [
        "Reassess pregnancy status and reproductive plans before tetracyclines, spironolactone, combined oral contraceptives, or retinoids; these agents are described as contraindicated during pregnancy. [20]",
        "Use smoking cessation and reduction of friction or mechanical stress as adjunctive risk modification, not as substitutes for anti-inflammatory or surgical treatment when active disease is moderate to severe. [22][18]"
      ],
      "subsections": [],
      "table": {
        "caption": "Targeted comorbidity assessment that changes HS management. [1][8][9][20]",
        "columns": [
          "Clinical trigger",
          "Assessment",
          "Management implication"
        ],
        "rows": [
          [
            "Obesity or cardiometabolic risk factors",
            "Assess for metabolic syndrome and its component abnormalities. [8]",
            "Treat identified cardiometabolic disease concurrently; HS is associated with metabolic syndrome. [8]"
          ],
          [
            "Chronic diarrhea, bleeding, abdominal pain, weight loss, or perianal symptoms",
            "Evaluate for inflammatory bowel disease. [9]",
            "Coordinate treatment selection with gastroenterology when IBD is suspected or established. [9]"
          ],
          [
            "Planned adalimumab",
            "Evaluate for active and latent TB and assess for serious infection. [1]",
            "Do not overlook infection risk; the label warns of serious infections and TB reactivation. [1]"
          ],
          [
            "Pregnancy or pregnancy planning",
            "Review current HS medications before prescribing. [20]",
            "Avoid oral tetracyclines, spironolactone, combined oral contraceptives, and retinoids during pregnancy. [20]"
          ]
        ]
      }
    },
    {
      "id": "medical-treatment",
      "eyebrow": "Inflammatory disease",
      "heading": "Choose systemic therapy by severity, prior response, and structural burden",
      "intro": "Medication reduces inflammatory activity; it should not delay definitive treatment of fixed tunnels and scarred tissue.",
      "paragraphs": [
        "For limited disease, topical antimicrobials such as clindamycin are used in practice; for more extensive or recalcitrant inflammatory disease, systemic antibiotics, antiandrogen therapy, retinoids, metformin, corticosteroids, and several immunomodulators have been used off label. Antibiotics are commonly employed but their evidence base is limited and HS is a chronic inflammatory condition rather than a primary infection. [1][17][22]",
        "For moderate-to-severe disease requiring FDA-approved systemic treatment, select among TNF and IL-17 pathway inhibitors in conjunction with dermatology-led longitudinal assessment. Adalimumab, secukinumab, and bimekizumab are identified as U.S.-approved therapies for moderate-to-severe HS; adalimumab has pivotal phase 3 trial evidence, and secukinumab demonstrated rapid improvement in moderate-to-severe disease in phase 3 study reporting. [2][6][18][23]",
        "Use the labeled adult HS adalimumab regimen: 160 mg subcutaneously initially, 80 mg subcutaneously at week 2, then 40 mg weekly or 80 mg every other week beginning 2 weeks later. This regimen is approved for adults with chronic moderate-to-severe HS; the indication also includes adolescents aged 12 years or older who weigh more than 30 kg. [1]",
        "Assess response with lesion counts and drainage rather than scar appearance alone. The common trial endpoint HiSCR requires at least a 50% reduction in total abscess and inflammatory nodule count; ongoing tunnel drainage, expanding fibrosis, or recurrent disease in the same scarred unit despite reduced inflammatory counts should prompt procedural reassessment rather than simply extending a failing medical-only strategy. [5][18]"
      ],
      "bullets": [
        "Use antibiotics as adjunctive anti-inflammatory therapy or while arranging escalation, not as proof that recurrent lesions are bacterial abscesses requiring repeated drainage. [17][22][20]",
        "Consider hormonal approaches only when the clinical pattern supports a hormonal contribution and pregnancy is excluded; combined oral contraceptives, spironolactone, and finasteride are off-label options listed for HS management. [1][20]",
        "For severe disease requiring rapid short-term control before surgery, intravenous ertapenem 1 g/day for 1 to 18 weeks has been described as a bridge to surgery; it lacks activity against Pseudomonas and should not be used when Pseudomonas coverage is required. [14]"
      ],
      "subsections": [
        {
          "heading": "Biologic therapy and surgery",
          "paragraphs": [
            "Do not routinely stop adalimumab solely because wide excision with secondary-intention healing is planned. A randomized study cited in the European S2k guideline found adalimumab could be combined safely with surgery, although it did not reduce surgical indications or extent; the guideline also notes that the effect of biologics on wound healing remains unresolved. [14]"
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Medication selection and escalation for inflammatory HS. [1][5][6][14][17][18][20][23]",
        "columns": [
          "Clinical situation",
          "Treatment direction",
          "Decision point"
        ],
        "rows": [
          [
            "Limited inflammatory lesions",
            "Topical clindamycin is among topical therapies used off label. [1]",
            "Escalate if lesion burden, pain, drainage, or recurrence is not controlled. [18]"
          ],
          [
            "More extensive inflammatory or recalcitrant HS",
            "Systemic antibiotics and selected metabolic or hormonal therapies are used off label. [1][17]",
            "Avoid treating antibiotics as definitive therapy for fixed tunnels or fibrosis. [18][22]"
          ],
          [
            "Moderate-to-severe HS requiring approved systemic therapy",
            "Use FDA-approved adalimumab, secukinumab, or bimekizumab as appropriate. [18][23]",
            "For adalimumab, use the approved HS loading and maintenance regimen and screen for TB/infection risk. [1]"
          ],
          [
            "Severe inflammatory disease while awaiting surgery",
            "Ertapenem 1 g/day IV for 1 to 18 weeks has been described as a surgical bridge. [14]",
            "Do not select ertapenem when Pseudomonas coverage is needed. [14]"
          ]
        ]
      }
    },
    {
      "id": "procedural-management",
      "eyebrow": "Destructive disease",
      "heading": "Refer tunnels and scarred anatomic units for definitive surgical management",
      "intro": "Procedure choice should address the diseased tissue volume, not merely evacuate an acute collection.",
      "paragraphs": [
        "Refer early for surgical evaluation when there are chronic draining tunnels, irreversible fibrosis, morbid scarring, or recurrent lesions within a fixed anatomic unit. Chronic inflammation produces tunnel formation and irreversible skin damage; once fibrosis is established, medical treatment can control only part of the symptom burden and definitive lesion management is surgical. [18][22]",
        "Use incision and drainage only when immediate evacuation of an acute abscess is clinically necessary, with explicit counseling that recurrence is common in HS. Repeated incision and drainage without a plan for the underlying tunnel network perpetuates episodic care and should trigger referral for excision-based or other definitive procedural planning. [20][1]",
        "Coordinate timing around inflammatory control rather than treating medical and surgical care as mutually exclusive. Adalimumab has been combined with wide excision and secondary-intention healing without an observed excess of postoperative complications or hemorrhage in cited evidence, but continued surveillance for infection and wound complications remains necessary. [14]"
      ],
      "bullets": [
        "Map all involved regions before surgery, including clinically silent extensions suggested by recurrent drainage or connected scarred openings; the procedural target is the diseased anatomic unit, not only the most recently inflamed nodule. [18]",
        "Use a combined medical-surgical plan for destructive disease with ongoing inflammation; use surgery alone when the region is primarily burned out scar and fibrosis with little medically modifiable inflammatory activity. [18]",
        "Escalate multidisciplinary management for anogenital, genitoanal, or extensive disease because reconstruction, wound care, pain management, and comorbidity coordination may determine feasibility and outcome. [18][15]"
      ],
      "subsections": [],
      "table": {
        "caption": "When to move from lesion drainage to definitive HS surgery. [14][18][20][22]",
        "columns": [
          "Finding",
          "Role of acute drainage",
          "Definitive next step"
        ],
        "rows": [
          [
            "Acute fluctuant abscess causing urgent symptoms",
            "Incision and drainage may provide immediate evacuation. [1][20]",
            "Plan follow-up because recurrence after drainage is common in HS. [20]"
          ],
          [
            "Persistent draining tunnel or recurrent scarred site",
            "Drainage alone does not address the structural lesion. [20][18]",
            "Refer for lesion-directed definitive surgical management. [18][22]"
          ],
          [
            "Wide destructive disease with active inflammation",
            "Treat the acute inflammatory burden while planning surgery. [18]",
            "Use combined medical and surgical care; adalimumab can be combined with wide excision and secondary-intention healing. [14]"
          ],
          [
            "Burnout disease dominated by fibrosis and scar",
            "Drainage is generally not a durable strategy. [18][20]",
            "Surgery may be the principal treatment for the involved region. [18]"
          ]
        ]
      }
    },
    {
      "id": "longitudinal-monitoring",
      "eyebrow": "Follow-up",
      "heading": "Monitor response by inflammatory burden, structural progression, and treatment safety",
      "intro": "A successful plan reduces new inflammation while preventing progression to irreversible tunnel and scar disease.",
      "paragraphs": [
        "At each therapeutic reassessment, compare inflammatory nodule and abscess counts, drainage, pain, flare frequency, and sites of new involvement with the baseline record. A reduction of at least 50% in total abscess and inflammatory nodule count is the HiSCR threshold used in pivotal HS trials; persistent disease below this response level supports changing or intensifying the treatment plan. [5][2][6]",
        "Monitor structural progression separately: new tunnels, expansion of scarred territory, recurrent drainage from an established tunnel, and increasing procedural complexity are escalation signals even when inflammatory lesion counts improve. Medical therapy targets the inflammatory phase, whereas destructive and burnout phases require increasing emphasis on surgery. [18]",
        "For patients receiving adalimumab, maintain vigilance for serious infection and tuberculosis during treatment because the product labeling warns about serious infections, including active TB and latent TB reactivation. Reevaluate systemic therapy promptly when infection is suspected rather than attributing fever, worsening drainage, or systemic symptoms to an ordinary HS flare. [1]"
      ],
      "bullets": [
        "Revisit smoking, friction, BMI, and cardiometabolic risk as measurable adjunctive targets at longitudinal visits. [22][8]",
        "Re-screen for gastrointestinal symptoms over time, particularly when new bowel symptoms appear, because HS has an established association with inflammatory bowel disease. [9]",
        "Document reproductive plans before any change to tetracyclines, hormonal agents, or retinoids. [20]"
      ],
      "subsections": [],
      "table": {
        "caption": "Follow-up signals that should change the HS management plan. [1][5][18][20]",
        "columns": [
          "Follow-up finding",
          "Interpretation",
          "Action"
        ],
        "rows": [
          [
            "At least 50% fall in abscess plus inflammatory nodule count",
            "Meets the HiSCR response threshold used in trials. [5]",
            "Continue assessment for residual drainage, new tunnels, and patient-important symptoms. [18]"
          ],
          [
            "Persistent inflammatory burden without meaningful lesion-count improvement",
            "Insufficient control of active disease. [5][18]",
            "Reassess adherence, treatment selection, and need for approved systemic therapy or escalation. [18][23]"
          ],
          [
            "New or persistent tunnels and fibrosis",
            "Structural progression despite or beyond medical control. [18][22]",
            "Obtain surgical evaluation for definitive management. [18]"
          ],
          [
            "Fever, suspected serious infection, or TB concern during adalimumab",
            "Potential labeled safety complication. [1]",
            "Evaluate urgently for infection and reassess ongoing biologic therapy. [1]"
          ]
        ]
      }
    }
  ],
  "faq": [
    {
      "question": "Should biologic therapy be stopped before HS excision?",
      "answer": "Not routinely on the basis of surgery alone: cited randomized evidence found adalimumab could be combined safely with wide excision and secondary-intention healing, although its effect on wound healing remains uncertain. Individualize decisions for active infection, wound risk, and perioperative context. [14]"
    }
  ],
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  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
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      "detail": "www.accessdata.fda.gov",
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      "snippet": "Analysis of Current Treatment Options Currently, there are only two FDA-approved therapies for HS: Humira (adalimumab) and Cosentyx (secukinumab). Adalimumab is a tumor necrosis factor blocker that was approved for the treatment of adults with chronic moderate to severe hidradenitis suppurativa on J",
      "score": 0.62330866
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      "host": "www.nejm.org",
      "snippet": "European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa.",
      "score": 0.45391592
    },
    {
      "number": 3,
      "title": "Hidradenitis suppurativa",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(24)02475-9.pdf",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by R Sabat · 2025 · Cited by 267 — Hidradenitis suppurativa is a chronic inflammatory disease characterised by painful, deep-seated nodules, abscesses, and draining tunnels in the ...Read more",
      "score": 0.30083847
    },
    {
      "number": 4,
      "title": "Brepocitinib, Zimlovisertib, and Ropsacitinib in Hidradenitis ...",
      "detail": "evidence.nejm.org",
      "url": "https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300155",
      "authors": "evidence.nejm.org",
      "host": "evidence.nejm.org",
      "snippet": "by AB Kimball · 2024 · Cited by 44 — Hidradenitis suppurativa (HS) is a chronic, disabling inflammatory skin disorder characterized by painful nodules and draining sinus tracts.Read more",
      "score": 0.2943777
    },
    {
      "number": 5,
      "title": "Efficacy and safety of bimekizumab in patients with moderate-to ...",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2824%2900101-6/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "The primary outcome was an hidradenitis suppurativa clinical response of at least 50%, defined as a reduction in total abscess and inflammatory",
      "score": 0.2343282
    },
    {
      "number": 6,
      "title": "Secukinumab in moderate-to-severe hidradenitis suppurativa ...",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00022-3/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "When given every 2 weeks, secukinumab was clinically effective at rapidly improving signs and symptoms of hidradenitis suppurativa with a favourable safety",
      "score": 0.2003702
    },
    {
      "number": 7,
      "title": "Hidradenitis suppurativa - The Lancet",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02475-9/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "Hurley staging was originally developed to identify candidates for surgical therapy, although it has been adopted as a severity measure in",
      "score": 0.5476824
    },
    {
      "number": 8,
      "title": "Association of Metabolic Syndrome and Hidradenitis Suppurativa",
      "detail": "jamanetwork.com",
      "url": "https://jamanetwork.com/journals/jamadermatology/fullarticle/1904927",
      "authors": "jamanetwork.com",
      "host": "jamanetwork.com",
      "snippet": "HS appears to be associated with MetS, indicating substantial comorbidities. Because this study is cross-sectional, causality remains to be explored. between",
      "score": 0.5914643
    },
    {
      "number": 9,
      "title": "Association of Hidradenitis Suppurativa With Inflammatory Bowel ...",
      "detail": "jamanetwork.com",
      "url": "https://jamanetwork.com/journals/jamadermatology/fullarticle/2737815",
      "authors": "jamanetwork.com",
      "host": "jamanetwork.com",
      "snippet": "This systematic review and meta-analysis investigates the associated risk of inflammatory bowel disease in patients with hidradenitis",
      "score": 0.53298485
    },
    {
      "number": 10,
      "title": "A centre-based ambulatory care concept for hidradenitis suppurativa ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bjd/article/189/2/170/7150370",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "For categorization over the course of the disease, the Hurley staging system was used.9 The International Hidradenitis Suppurativa Severity Score System (IHS4",
      "score": 0.6366926
    },
    {
      "number": 11,
      "title": "Hidradenitis Suppurativa Area and Severity Index (HASI) - Ovid",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bjd/article-pdf/182/1/240/47251115/bjd0240.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "BSA estimation had a strong positive relationship with Hurley staging, IHS4, HS-PGA and total lesion counts (q > 0486).",
      "score": 0.6102915
    },
    {
      "number": 12,
      "title": "and intrarater reliability of Hurley staging for hidradenitis suppurativa",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bjd/article/181/2/344/6602556",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "In conclusion, Hurley staging is reliable for rapid assessment of HS, and it is best for assessing Hurley stage III disease for all of the most involved",
      "score": 0.54681134
    },
    {
      "number": 13,
      "title": "Clinical response rate and flares of hidradenitis suppurativa in ... - Ovid",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/ced/article-pdf/45/4/438/46309519/ced0438.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Number of flares subdivided by. IHS4 score and Hurley stage and IHS4 score are indicated in Fig. 1b and Fig. 1c. Effect of adalimumab treatment. A progressive",
      "score": 0.48279548
    },
    {
      "number": 14,
      "title": "European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment - Zouboulis - 2025 - Journal of the European Academy of Dermatology and Venereology - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.20472",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "complications or haemorrhage was observed with adalimumab versus placebo.238-241 Antibiotics may be continued during biologic therapy. [...] relative to surgery did not impact efficacy. Patients who received HS surgery with biologic therapy were most likely to achieve a 75% reduction in inflammatory",
      "score": 0.63804686
    },
    {
      "number": 15,
      "title": "Two‐Stage Surgical Management of Anogenital Hidradenitis ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.70874",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Systemic antibiotics (clindamycin–rifampicin or tetracycline-based) or biologics such as adalimumab may partially control inflammation and",
      "score": 0.63723457
    },
    {
      "number": 16,
      "title": "Surgical treatment of hidradenitis suppurativa: case series and ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/j.1742-481X.2006.00235.x",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Standard management includes the use of topical and systemic antibiotics such as clindamycin and tetracyclin and topical antimicrobials. Other",
      "score": 0.5925965
    },
    {
      "number": 17,
      "title": "Epidemiology and Diagnostic Tools (Clinical Phenotypes, Outcome ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/exd.14342?af=R",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Antibiotics are used for hidradenitis suppurativa management with limited evidence. Choice of antibiotics is based on small randomized",
      "score": 0.53269315
    },
    {
      "number": 18,
      "title": "Hidradenitis suppurativa - ScienceDirect.com",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0140673624024759",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "of hidradenitis suppurativa is complex and includes innate immune mechanisms (eg, macrophages, neutrophils, IL-1β, tumour necrosis factor [TNF], and granulocyte colony-stimulating factor), T-cell mechanisms (eg, IL-17 and IFN-γ), and B-cell mechanisms (eg, associated with dermal tertiary lymphatic s",
      "score": 0.5255399
    },
    {
      "number": 19,
      "title": "Integrated multidisciplinary approach to hidradenitis suppurativa in ...",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2352647520300186",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Twelve patients received antibiotics, 9 received biologics, 9 underwent medico-surgical treatment, 9 underwent surgery, and 10 were lost to follow-up.",
      "score": 0.514718
    },
    {
      "number": 20,
      "title": "A concise clinician’s guide to therapy for hidradenitis suppurativa",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2352647519301224",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Some common medications used in the management of HS that are contraindicated during pregnancy include oral tetracyclines, spironolactone, combined oral contraceptive pills, and retinoid therapies (Nesbitt et al., 2020; Perng et al., 2016). However, there are still many medications that can be used ",
      "score": 0.4808937
    },
    {
      "number": 21,
      "title": "Hidradenitis suppurativa: Current and emerging treatments",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0190962219328269",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "### J Am Acad Dermatol\n\n### MABp1 targeting IL-1α for moderate to severe hidradenitis suppurativa not eligible for adalimumab: a randomized study\n\n### J Invest Dermatol\n\n### Combined biologic therapy for the treatment of psoriasis and psoriatic arthritis: a case report\n\n### JAAD Case Rep\n\n### Combin",
      "score": 0.48074743
    },
    {
      "number": 22,
      "title": "[PDF] Secukinumab - European Medicines Agency",
      "detail": "www.ema.europa.eu",
      "url": "https://www.ema.europa.eu/nl/media/7734",
      "authors": "www.ema.europa.eu",
      "host": "www.ema.europa.eu",
      "snippet": "al 2022, Van Straalen KR et al 2020). It is estimated that approximately 41 percent of pediatric patients with HS have a family history of HS (Liy-Wong C et al 2021). Compared with other HS patients, patients with early-onset HS (onset prior to age 13) may be more likely to have a family history of ",
      "score": 0.7703443
    },
    {
      "number": 23,
      "title": "Hidradenitis suppurativa: Diagnosis and treatment",
      "detail": "www.aad.org",
      "url": "https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-treatment",
      "authors": "www.aad.org",
      "host": "www.aad.org",
      "snippet": "Alikhan A, Sayed C, et al. “North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations Part II: Topical, intralesional, and systemic medical management.” J Am Acad Dermatol 2019;81:91-101.\n\nBrunk ",
      "score": 0.73642004
    },
    {
      "number": 24,
      "title": "Hidradenitis suppurativa: Causes",
      "detail": "www.aad.org",
      "url": "https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-causes",
      "authors": "www.aad.org",
      "host": "www.aad.org",
      "snippet": "While what causes HS is still a mystery, these findings have given us a better understanding of what causes HS and also led to better ways to treat this condition. Today, treatment often requires a multi-pronged approach that includes medication, skin care, and self-care.\n\nFind out how dermatologist",
      "score": 0.6641271
    }
  ],
  "publishedAt": "2026-09-15T23:22:35.357066+00:00",
  "updatedAt": "2026-09-15T23:22:35.357066+00:00",
  "readingMinutes": 7,
  "slug": "hidradenitis-suppurativa"
}