Topical Conversations

Amit Garg, MD, and Jennifer Hsiao, MD, take a practical look at how to judge whether HS treatment is working, beyond lesion counts alone. They share the questions they ask in clinic about day-to-day symptoms, flare frequency and severity, pain, quality of life, and signs of progression, and why a therapy generally needs 3 to 4 months before its response can be fairly assessed. The conversation also covers why earlier control of inflammation matters in a progressive disease, before tunnels and scarring become harder to reverse, and why framing HS as inflammation rather than infection helps patients understand the move beyond repeated antibiotics. With more advanced therapies available and others in development, Garg and Hsiao discuss how prior treatments, efficacy and safety, mechanism of action, route of administration, comorbidities, and patient preference can guide the next decision, and how more options let clinicians move on from a partial response rather than staying with it too long.

In this quick-hitting installment of Topical Conversations, Andrea Murina offers a few tips on some first-visit essentials when counseling your patients on managing their flares associated with hidradenitis suppurativa (HS). The patient education conversationShe encourages dermatologists to initiate conversations about managing HS flares at the patient's first visit and advises educating patients on various ways to handle acute flares. She suggests advising patients to use warm compresses and utilize both topical and oral pain relievers to alleviate symptoms. Furthermore, Dr Murina encourages patients to return to the office if necessary, particularly if they require intralesional Kenalog injections or oral antibiotics. A proactive approach to empower patientsTo empower patients and give them a sense of control over their condition, Dr Murina suggests prescribing oral antibiotics for patients to have on hand in case of a flare-up. By proactively addressing flare management strategies, dermatologists can improve outcomes and enhance overall quality of life for patients with HS.

In this installment of Topical Conversations, Andrea T. Murina, MD, associate professor and residency program director at Tulane School of Medicine, offers a few quick-hitting tips on making the patient exam a comfortable and low-stress experience for those with hidradenitis suppurativa. Planning ahead to put the patient at ease Dr Murina emphasizes the significance of ensuring patient comfort throughout the examination process. To achieve this, she suggests several strategies. Firstly, providing patients with a gown and instructing them to undress ahead of time can help them feel more at ease in the exam room. Additionally, offering wound care supplies and any other necessary items in advance can further enhance their comfort and offer a convenient experience by anticipating their needs. Prioritizing patient comfort During the examination itself, Dr Murina stresses the importance of being gentle and careful with patients. She underscores the need for sensitivity to their potential pain and discomfort, encouraging practitioners to ask patients about their pain levels throughout the examination. By prioritizing patient comfort and attentiveness during the assessment of HS, dermatologists can create a supportive and reassuring environment that fosters trust and cooperation.