Looking for a dermatologist to offer commentary on clinical takeaways for physicians on hidradenitis suppurativa and cardiometabolic risk, treatment options like GLP-1RAs, and psychosocial challenges.

Shamsa Kanwal, M.D., is a board-certified Dermatologist with over 10 years of clinical experience. She currently practices as a Consultant Dermatologist at https://www.myhsteam.com/, which is a community-made specifically to treat HS. Profile link https://www.myhsteam.com/writers/6841af58b9dc999e3d0d99e7 My top clinical takeaway is to treat HS as a systemic disease. Screen at baseline for cardiometabolic risks including BMI or waist, blood pressure, lipids, and HbA1c, then repeat yearly. Counsel on smoking cessation, friction and heat reduction, and weight management, since even modest loss can reduce flares. I set a clear plan for pain, drainage control, and antibiotics, and I escalate early to disease modifying therapy rather than cycling short courses. On treatment options, I use adalimumab as the established biologic and consider other targeted agents when access allows. Hormonal therapy helps select women, and short courses of clindamycin plus rifampin can bridge while biologics start. Regarding GLP 1 receptor agonists, early real world experience suggests they can help by driving weight loss and improving insulin resistance, which often lowers flare frequency. They remain off label for HS, so I co manage with primary care or endocrinology, start low and titrate, and monitor for GI effects, gallbladder issues, and access barriers. Psychosocial burdens are significant. Many patients live with pain, drainage, odor, and scarring that affect work, intimacy, and mood. I screen routinely for depression and anxiety, offer wound care education to reduce odor and leakage, and provide letters for workplace accommodations. As per my experience, small practical wins such as breathable clothing guidance, silicone dressings, and reliable analgesia restore confidence while medical therapy takes effect. For busy teams, the move that changes outcomes is a simple pathway that pairs metabolic screening with early biologic referral, clear wound care steps, and mental health screening at every visit. That integrated approach is what turns HS care from crisis management into steady control.

Good Day, What are important clinical messages for doctors with respect to HS and cardiometabolic risk? HS is not merely a skin disease. It is a systemic inflammatory disorder based on obesity, insulin resistance, and cardiovascular risk. Doctors should routinely check their patients of HS against the metabolic syndrome and work with other specializations to manage future long-term health risks as early as possible. What are the treatment choices, including possible use of GLP-1 receptor agonists (GLP-1RAs)? Just about any standard therapy: antibiotics, hormonal therapy, biologics will help but not all. GLP-1RAs are certainly used for the treatment of diabetes and obesity, and these have shown some promise in decreasing HS flares and inflammation, especially among patients with metabolic comorbidities, although they are not standard yet. What are some psychosocial problems of HS patients? HS has a heavy emotional burden. The chronic pain and scarring and stigmatizing conditions often result in isolation, depression, and anxiety. Screening and openness are very important. Multidisciplinary supportive health care actually improves many measures of quality of life. If you decide to use this quote, I'd love to stay connected! Feel free to reach me at gregorygasic@vmedx.com and outreach@vmedx.com.

Hidradenitis suppurativa (HS) is starting to be identified as not merely a skin disease- it is directly related to cardiometabolic health issues such as obesity, insulin resistance and cardiovascular disease. Clinicians will also begin to screen HS patients with metabolic comorbidities, as a lasting outcome may be achieved by treating both the skin disease and the underlying systemic health issues. GLP-1 receptor agonists have potential in the treatment of the disease, specifically in obese individuals with HS, who may lose weight and some of their inflammatory burden. The other cost that cannot be underestimated, in addition to medical management, is the psychosocial cost of HS. This can be catastrophic, especially for mental health, quality of life and the presumption and constant pain the other periods were getting progressively worse. Such patients would also experience significant benefits related to multidisciplinary care, including dermatology, primary care, endocrinology, and mental health assistance.