- The US and Canadian Hidradenitis Suppurativa Foundations have released clinical management guidelines for the diagnosis, evaluation, and management of hidradenitis suppurative (HS).
Why this matters
- Understanding and treatment of HS is evolving rapidly, and current HS management strategies use variable activity and outcome measures.
- Clinical performance Hurley staging and inflammatory lesion counts are recommended for grading and classification.
- Screening for metabolic syndrome, depression, anxiety, diabetes, polycystic ovary syndrome, and tobacco abuse is recommended.
- Recurrent nodules and tunnels may be treated with deroofing or excision; incision and drainage is recommended only for acute abscesses to relive pain; and wide local scalpel, CO2, or electrosurgical excision is appropriate for extensive chronic lesions.
- Individualized, carefully prescribed short-acting opioid analgesics may be needed in select cases of severe pain.
- Nd:YAG laser is recommended in Hurley stage II/III patients based on RCT and case series data and in Hurley stage I diseases based on expert consensus, whereas CO2 laser excision is recommended in Hurley II/III patients with fibrotic sinus tracts.
- Guidelines were based on a primary literature review concluded on March 16, 2017, and selected updates of high clinical impact through December 1, 2018.
- Funding: None.