Diagnosing Hidradenitis Suppurativa | HS Awareness

An early diagnosis of hidradenitis suppurativa (HS) can help mitigate disease burdens¹

HS can be challenging to diagnose as the clinical characteristics may be difficult to identify or mistaken for other conditions. But the consequences of a delayed HS diagnosis can be damaging and may even be permanent. Recognizing the characteristic lesions of HS and how they present across different skin tones can help get patients the care they need to help inhibit further disease progression.^1-4

Fact prompting HCPs to talk to their patients about the possibility of having HS

CLINICAL ASSESSMENT

SKIN OF COLOR

There are 3 essential diagnostic criteria that can help distinguish HS from other skin conditions⁶

	LESIONS One or more painful, inflammatory, deep-seated nodules, abscesses, or comedones.³
	LOCATION Lesions are most common on flexural sites, like the axillae, inframammary, groin, perineal and perianal regions. They are less common on ears, face, scalp, back, chest, or legs.^3,6
	CHRONICITY Recurrence at least twice within 6 months and/or persistence of at least 3 months^2,7

Know HS when you see it

Early HS lesions may resemble other dermatological conditions. Knowing the common presentations, common differential diagnoses, and stage of disease can help you identify HS more quickly and make referrals to HS-treating dermatology providers sooner.²

CHARACTERISTIC HS LESIONS^9-15

Abscess image — Abscess
Image of abscess of HS patient provided by *Dermatology Online Journal*, copyright Noah Scheinfeld, MD.

Nodule image — Nodule
Image of nodule of HS patient provided by *DermNet.*

Follicular papule image — Follicular papule/pustule
Image of follicular papules/pustules of HS patient provided by *Dermatology Online Journal*, copyright Noah Scheinfeld, MD.

Tunnel image — Tunnel
Image of sinus tract/fistula of HS patient provided by *Experimental Dermatology.*

Scar image — Scar/cord
Image of cord/scar of HS patient provided by *Dermatology Online Journal*, copyright Noah Scheinfeld, MD.

Comedone image — Comedone
Image of comedones of HS patient provided by *American Family Physician.*

DIFFERENTIAL DIAGNOSIS^2,9,10,16,17

Folliculitis image — Folliculitis
Image provided by *International Journal of Dermatology.*

Carbuncle image — Carbuncle
Image provided by Science Source.

Cutaneous Crohn's disease image — Cutaneous Crohn's disease
Image provided by *British Medical Journal.*

Acne vulgaris image — Acne vulgaris
Image provided by *Journal of Clinical and Aesthetic Dermatology.*

Intergluteal pilonidal cysts image — Intergluteal pilonidal cysts
Image provided by Science Source.

Pyogenic granuloma
Image of granuloma provided by iStock.

STAGING HS^3,18

Mild image — MILD
^{Image of inframammary fold of HS patient provided by Dr Ali Moiin.}
Sometimes described as Hurley Stage 1.
Typically presents as 1 or more nodules with no to minimal scarring or tunnel formation.

Post-Inflammatory Hyperpigmentation image — MODERATE
^{Image of axilla of HS patient provided by Science Source.}
Sometimes described as Hurley Stage 2.
Typically presents as multiple nodules along with limited tunneling and/or scarring.

Severe image — SEVERE
^{Image of axilla of HS patient provided by Science Source.}
Sometimes described as Hurley Stage 3.
Typically presents as multiple or extensive interconnected tunnels, nodules, and scarring.

HS can appear differently depending on skin tone¹⁹

Hidradenitis suppurativa disproportionally affects patients of color and is associated with increased disease severity. Knowing the clinical presentations of HS on darker skin tones may help you accurately identify HS.^4,19

Presentations of HS unique to patients of color


SUBTLE ERYTHEMA²⁰	VIOLACEOUS, DARK BROWN, AND GRAY LESIONS²⁰	POST-INFLAMMATORY HYPER-PIGMENTATION^1,21	KELOIDS²²
Image of axilla of HS patient provided by Science Source.	Image of groin of HS patient provided by Dr Ali Moiin.	Image of axilla of HS patient provided by Science Source.	Image of chest provided by Science Source.

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The healthcare providers featured in these videos were compensated for their time. These videos represent their opinions and do not represent the opinions of Novartis.

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An early diagnosis of hidradenitis suppurativa (HS) can help mitigate disease burdens1

There are 3 essential diagnostic criteria that can help distinguish HS from other skin conditions6

Know HS when you see it

CHARACTERISTIC HS LESIONS9-15

Abscess

Nodule

Follicular papule/pustule

Tunnel

Scar/cord

Comedone

DIFFERENTIAL DIAGNOSIS2,9,10,16,17

Folliculitis

Carbuncle

Cutaneous Crohn's disease

Acne vulgaris

Intergluteal pilonidal cysts

Pyogenic granuloma

STAGING HS3,18

MILD

MODERATE

SEVERE

HS can appear differently depending on skin tone19