The Dermatologist’s Role in Early HS Recognition and Long-Term Patient Outcomes

In this episode, ‘The Dermatologist's Role in Early HS Recognition and Long-Term Patient Outcomes,’ the panelists explore why dermatology is the specialty best equipped to take ownership of HS care. Dr. Resnik argues that dermatologists are natural leaders in HS management because of their visual diagnostic expertise, noting that once a clinician learns to recognize the full clinical picture of HS, including atypical presentations such as pyoderma gangrenosum on the legs or scalp involvement, they will never miss it again. Dr. Hsiao builds on this by emphasizing that HS requires both medical and surgical management, making dermatology the ideal specialty to serve as quarterback of care, coordinating referrals to other specialties and ensuring patients are screened for comorbidities through primary care. She expresses a vision in which HS becomes as routine a part of dermatology practice as psoriasis or eczema rather than being confined to specialty centers.

The conversation then turns to the critical importance of early treatment initiation. Dr. Resnik uses two vivid metaphors to convey urgency to patients, comparing untreated HS to driving down a one-way street where damage accumulates irreversibly, and to putting out a fire in only one room of a burning house. He draws a parallel to the evolving approach to acne, arguing that waiting for disease to worsen before initiating effective therapy is no longer acceptable. Dr. Hsiao reinforces this position by stressing that helping patients understand HS as a chronic inflammatory condition rather than an infection is foundational to gaining their acceptance of immunomodulatory therapies targeting TNF and interleukin-17. She also reframes the risk conversation, urging clinicians to highlight the very real dangers of leaving HS untreated, including depression, debilitation, and disability, rather than focusing solely on potential medication side effects. Both physicians agree that treating earlier, preventing tissue d

The next episode in this series, ‘Overcoming the Obstacles to Effective HS Treatment,’ features the panelists advancing their conversation on HS and focusing on the multifaceted reasons why so many patients with moderate to severe HS remain undertreated, from patient-side medical fatigue and distrust to physician hesitancy and the exhausting prior authorization process that stands between patients and the therapies they need.