Surgical Collaboration Strengthens HS Outcomes Across Disease Stages

At the recent 10th Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) hosted by the HS Foundation, Ralph George, MD, FRCS, presented “Procedural Interventions Across the Spectrum of HS.”

George, associate professor and director of the CPD Department of Surgery at the University of Toronto, executive board member of the Canadian Hidradenitis Suppurativa Foundation, and medical director of the CIBC Breast Centre in Toronto, spoke with Dermatology Times to review the highlights from his session and the benefits of the 2025 SHSA meeting.

Q: What is the main takeaway from your session?

George: As a surgical oncologist, my principal point is that surgery is working better and better for hidradenitis suppurativa, and honestly, it isn't because of the surgeons. It's because the other treatments are really starting to make a difference, and that's allowing surgery to really make even more of a difference than it ever did. The real benefit has been the collaboration.

Q: What other key pearls from your session would you share with colleagues?

George: A lot of patients don't like surgery or think of it as something that they don’t necessarily want to do. Surgery is not mandatory. It can certainly help, though, in hidradenitis suppurativa; it can help at almost any level.

For instance, someone with very mild disease that's very localized may be able to avoid longer forms of treatment, provided it's localized. So, it's something that can be used if you have it available across the spectrum of hidradenitis suppurativa. It isn't just for the horrible, horrible cases. It can help people with mild disease too, if it's localized. So, it can be used across the spectrum.

Q: Is there any new research or advancement that you think is important to highlight in HS?

George: There's quite a bit. Actually, it's hard to keep up with hidradenitis suppurativa, and that's part of what's making it so exciting right now. Realistically, surgery has been around for a long time, and we're kind of the sticks in the mud. It's what's happening in the bench research, it’s what's happening in the clinical trials, and really that's what's impacting surgeons’ ability to help this disease in an even greater way.

Q: What is the value of a disease-specific meeting such as SHSA?

George: There are not many meetings like this one. There are some in breast cancer where it's disease-specific, but it isn't participant-specific. Usually, I go to a meeting and it's sarcoma surgeons or it's breast cosmetic surgery. This meeting has a different atmosphere or feel to it.

It's a PhD molecular biologist sitting with a patient, sitting with a surgeon, sitting with a dermatologist, and I think that's a unique dynamic, and it's just too bad more meetings aren't like that. We all bring something, and I think we're all better from each other.

Q: What closing remarks would you share about HS?

George: We still have a long way to go in hidradenitis suppurativa. You look at a disease like breast cancer; the role of surgery is actually becoming, for most people, less and less, and hopefully we'll see that in hidradenitis suppurativa someday as well. I don't mind if the advances put me out of business, and hopefully that'll happen someday.