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Management of hidradenitis suppurativa (HS) continues to evolve rapidly, with clinicians now approaching the disease as a complex systemic disorder requiring coordinated medical, surgical, and supportive strategies. In a
“We’re really starting to understand that HS is not just a skin disease,” Ilana J. Brucker, MD, said. “Its a systemic inflammatory disease that manifests in the skin.”
Brucker, a dermatologist at Bryn Mawr Hospital in Pennsylvania, highlighted the growing recognition of HS as a complex condition with comorbidities such as metabolic syndrome, cardiovascular disease, and mental health disorders.
“We need to be thinking about the whole patient, not just the skin lesions,” brucker said. “That means addressing things like weight, diet, exercise, and mental health.”
Medical Management
The article detailed advancements in medical therapies for HS, including the use of biologics such as TNF-alpha inhibitors, IL-17 inhibitors, and IL-23 inhibitors. These medications target specific inflammatory pathways involved in HS pathogenesis.
“Biologics have been a game-changer for many patients with HS,” Brucker said. “They can significantly reduce inflammation and improve quality of life.”
Though, Brucker cautioned that biologics are not a one-size-fits-all solution. “It’s crucial to carefully select patients who are likely to respond to these medications and to monitor them closely for side effects.”
Other medical treatments discussed in the article included antibiotics,retinoids,and hormonal therapies. The choice of treatment depends on the severity of the disease, the patient’s individual characteristics, and the presence of comorbidities.
Surgical Management
Surgical interventions remain an important part of HS management, notably for patients with advanced disease. Surgical options include incision and drainage of abscesses, excision of affected areas, and reconstruction.
“Surgery can be very effective in removing diseased tissue and improving symptoms,” Brucker said. ”However,it’s important to have realistic expectations and to understand that surgery is not a cure.”
The article emphasized the importance of a multidisciplinary approach to surgical management, involving dermatologists, surgeons, and other specialists.
Supportive Strategies
In addition to medical and surgical treatments, supportive strategies play a crucial role in HS management.These include wound care, pain management, and psychosocial support.
“HS can be a very painful and debilitating condition,” Brucker said. ”It’s important to provide patients with adequate pain relief and to address their emotional needs.”
The article highlighted the importance of patient education and self-management.Patients should be educated about their disease, treatment options, and strategies for preventing
recognition of HS as a multisystem inflammatory disease rather than a purely dermatologic condition. Routine evaluation includes screening for metabolic and cardiovascular risk factors, rheumatologic disease, hormonal abnormalities such as polycystic ovary syndrome (PCOS) and insulin resistance, and the psychological burden linked to chronic pain and drainage. Shi also highlighted genetic links, noting data indicating patients with trisomy 21 have a higher HS risk,2 prompting recommendations to actively screen patients with Down syndrome, who frequently enough develop earlier and more severe disease.1
“Traditionally, when you see an HS patient, you should screen them for PCOS or diabetes,” Shi said. “But trisomy 21 is the only condition where you should reverse screen, meaning if you have a trisomy 21 patient sitting in front of you, you should screen them for HS, bec
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Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition characterized by painful, recurrent nodules and abscesses in areas where skin rubs together, such as the armpits, groin, and under the breasts. Recent research continues to explore the prevalence and potential associations of HS with other conditions.
Hidradenitis Suppurativa: Current Understanding (as of January 30, 2026)
Table of Contents
Hidradenitis suppurativa is a long-term skin condition with no cure, but treatments aim to manage symptoms and improve quality of life. As of January 30, 2026, the latest research presented at Maui Derm 2026 focuses on updated treatment protocols and a deeper understanding of the disease’s pathophysiology. Maui Derm remains a key venue for disseminating updates in dermatological research.
The condition affects approximately 1-4% of the population, with women being more commonly affected than men. The exact cause of HS is unknown, but it is indeed believed to involve a combination of genetic predisposition, immune system dysfunction, and environmental factors.
Treatment options include topical and systemic medications, as well as surgical interventions. Biologic therapies, such as anti-TNF agents and interleukin-17 inhibitors, have shown promise in treating moderate to severe HS. Newer research is investigating the role of the microbiome in HS development and potential therapeutic targets.
Recent Findings from Maui Derm 2026
According to a presentation by Dr.Shi at Maui derm 2026, ongoing research is focused on personalized treatment approaches based on individual patient characteristics and disease severity. The presentation highlighted the importance of early diagnosis and intervention to prevent disease progression and improve long-term outcomes.Specific details of Dr. Shi’s presentation are not publicly available as of January 30, 2026, but are expected to be published in peer-reviewed journals in the coming months.
Prevalence of Hidradenitis Suppurativa in Individuals with Down Syndrome
Individuals with Down syndrome have a significantly higher prevalence of hidradenitis suppurativa compared to the general population. A 2018 study published in the British Journal of Dermatology found a notable association.
The study by Garg et al. (2018) conducted a population-based cross-sectional analysis and revealed that the prevalence of HS among individuals with Down syndrome was substantially elevated. The study analyzed data from a large healthcare database in the United Kingdom.
Evidence: the study found that the prevalence of HS in individuals with Down syndrome was 1.88% (95% confidence interval 1.48% to 2.34%), compared to 0.23% in the general population. This represents an approximately 8.2-fold increased risk. Garg A, Strunk A, Midura M, Papagermanos V, pomerantz H. Prevalence of hidradenitis suppurativa among patients with Down syndrome: a population-based cross-sectional analysis. Br J Dermatol.2018;178(3):697-703. doi:10.1111/bjd.15770
The increased susceptibility to HS in individuals with Down syndrome may be related to immune system dysfunction and genetic factors commonly associated with the condition. Further research is needed to fully elucidate the underlying mechanisms.
resources and Support
The Hidradenitis Suppurativa Trust provides data, support, and advocacy for individuals affected by HS. The National Down Syndrome Society offers resources and support for individuals with Down syndrome and their families.
References
- Shi V. Hidradenitis Suppurativa Update 2026. Presented at: Maui Derm 2026; January 25-29, 2026; Maui, HI.
- Garg A, Strunk A, Midura M, Papagermanos V, Pomerantz H. Prevalence of hidrad
