Hidradenitis Suppurativa (HS) is a chronic, complex condition requiring a multi-disciplinary approach for optimal management. Different specialists contribute to the treatment based on the severity, comorbidities, and patient needs:
Primary Care Providers (PCPs)
- Role:
- Often the first to evaluate and diagnose HS.
- Provide initial management with topical therapies and systemic antibiotics.
- Monitor for comorbidities such as obesity, metabolic syndrome, and depression.
- Refer to specialists when advanced care is required.
Dermatologists
- Role:
- Primary specialists for HS treatment. BILLING
- Diagnose and classify HS based on clinical presentation (e.g., Hurley staging).
- Prescribe advanced therapies like biologics (e.g., Adalimumab).
- Administer minor procedures like intralesional corticosteroid injections and laser treatments.
- Manage chronic skin complications, including scarring and recurrent infections.
Surgeons
- Role:
- Handle severe or refractory cases where surgical intervention is necessary.
- Perform procedures such as:
- Incision and drainage (I&D) for acute abscesses.
- Wide excision of affected areas for advanced disease with sinus tracts.
- Skin grafting or reconstruction in complex cases.
- Collaborate with dermatologists for combined medical and surgical care.
Pain Management Specialists
- Role:
- Manage chronic pain associated with HS, especially in severe or long-standing cases.
- Provide pharmacologic pain management (e.g., NSAIDs, opioids, nerve blocks).
- Utilize non-pharmacological approaches such as physical therapy.
Endocrinologists
- Role:
- Address hormonal contributions, particularly in female patients with polycystic ovary syndrome (PCOS) or androgen excess.
- Assist with metabolic disorders (e.g., diabetes, obesity) that can exacerbate HS.
Psychiatrists/Psychologists
- Role:
- Support patients dealing with the psychological impact of HS, including depression, anxiety, and social isolation.
- Provide counseling or therapy to improve coping strategies and quality of life.
- Address body image concerns and emotional well-being.
Dietitians/Nutritionists
- Role:
- Help manage weight and design anti-inflammatory diets to reduce HS flares.
- Advise on dietary modifications, such as reducing high glycemic foods and dairy intake.
Rheumatologists
- Role:
- Manage patients with HS-related inflammatory arthritis or associated autoimmune conditions like Crohn’s disease.
- Prescribe systemic immunomodulators (e.g., methotrexate) or biologics when indicated.
Wound Care Specialists
- Role:
- Provide care for non-healing wounds and ulcers associated with HS.
- Manage chronic sinus tracts and infected lesions using advanced wound care products.
Who Should a Patient See First?
- Patients should start with their Primary Care Provider (PCP) or a Dermatologist, who will initiate treatment and coordinate referrals to other specialists as needed.
This collaborative approach ensures comprehensive care for patients with HS, addressing both the physical and psychological aspects of the disease.
