North American Clinical Management Guidelines for Hidradenitis Suppurativa: A Publication from the United States and Canadian Hidradenitis Suppurativa Foundations

The North American clinical management guidelines for hidradenitis suppurativa (HS) provided a comprehensive overview of treatment strategies available up to 2018, emphasizing a combination of medical and surgical approaches. Treatments included topical therapies, systemic antibiotics, hormonal therapies, and immunomodulating medications, with a therapeutic algorithm based on Hurley staging to guide decisions. Despite increasing evidence for various treatments, no standardized management protocol existed in North America at the time. Adalimumab was frequently cited as effective for severe HS, while other treatments like infliximab, anakinra, and ustekinumab showed mixed results. The guidelines highlighted the need for individualized treatment plans due to variability in patient response and disease severity, and they called for more robust research to improve evidence-based management strategies.