Hidradenitis Suppurativa: Practical Tips and Considerations Regarding Diagnosis, Treatment, and Patient Communication

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EP: 1.Hidradenitis Suppurativa: Practical Tips and Considerations Regarding Diagnosis, Treatment, and Patient Communication

EP: 2.Hidradenitis Suppurativa: Overview, Patient Burden, and Challenges to Diagnosis

EP: 3.Disease Severity and the Role of Progression in Hidradenitis Suppurativa

EP: 4.Treatment Guidelines and the Role of Biologics in the Treatment of Hidradenitis Suppurativa

EP: 5.Navigating Hidradenitis Suppurativa Chronicles

Hi, and welcome to this Dermatology Times Partner Perspective video series. I’m Tiffany Mayo, associate professor, vice chair of diversity and inclusion, and director of the clinical research unit at the Heersink School of Medicine department of dermatology at the University of Alabama at Birmingham. In the first video, we discussed the clinical features, patient burden, and challenges of diagnosis of hidradenitis suppurativa, or HS. In this final video, I’ll wrap up the conversation with a few final thoughts.

This episode, "Hidradenitis Suppurativa: Practical Tips and Considerations Regarding Diagnosis, Treatment, and Patient Communication" is sponsored by Novartis, and I have been compensated for my time.

I mentioned in the first video that the average time of delay in HS diagnosis is 7 to 10 years.^1-3 During this delay, patients see an average of 3 different providers and receive 3 misdiagnoses before receiving the correct diagnosis, which is typically given by a dermatologist.³ These are general statistics, but I can share here that most of my patients report similar real-world experiences. From the patient perspective, this delay causes frustration and distrust. From a disease management perspective, a delayed diagnosis can lead to greater difficulty in resolving HS symptoms and progression.³

Upon diagnosis, it is important to name the condition and help the patient understand what it is and how and why it needs to be treated. Patients with HS frequently have questions that can culminate in a time-intensive visit, involving at least 30 minutes of extensive counseling and additional time for prior authorization of medications.⁴ It’s understandable that recurrent visits of this type may not be practical for all HCPs; however, we are all responsible for ensuring that patients are accurately diagnosed and are on the right track for optimal disease management. Collaborating with local HS experts or other physicians who can help manage the disease is key when this is the case. Because there can be a delay in access to these physicians, it is recommended to start patients on an initial regimen but inform them that they will require follow-up and, likely, treatment escalation that will be handled by a colleague you are able to name.⁴

Resources are also available to help with patient education and disease management. Foundations such as the US and Canadian HS Foundations play an important role in educating patients and clinicians through symposiums and other efforts.⁵ There are many tools HCPs can find helpful, including prior authorization templates, treatment guidelines, and HS specialty clinic directories.⁵

I would like to summarize this video series by reiterating HS is a chronic, painful disease with a substantial impact on patient quality of life. There is typically a delay in time to accurate diagnosis and the disease is often suboptimally managed. Though more work is needed, we can support our patients by helping them understand the disease and by appropriately managing it. Thank you to our viewers for watching.

References

1. Atzori L et al. Clinical Dermatology. 2017;5(1):1-4.

2. Garg A et al. J Am Acad Dermatol. 2020;82(2):366-376.

3. Snyder CL et al. Clin Cosmet Investig Dermatol. 2023;16:1833-1841.

4. Flood KS et al. J Am Acad Dermatol. 2021;84(3):e155-e160.

5. HS Foundation. Accessed May 6, 2024. https://www.hs-foundation.org/