Joint American Academy of Dermatology-Hidradenitis Suppurativa Foundation guidelines of care for the management of hidradenitis suppurativa.

BACKGROUND

Hidradenitis suppurativa affects 0.7% to 1.5% of the global population and causes substantial disability and meaningfully impairs quality of life.

OBJECTIVE

To provide evidence-based recommendations for the management of hidradenitis suppurativa.

METHODS

A workgroup conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess the certainty of evidence and to develop recommendations.

RESULTS

This guideline presents 37 evidence-based recommendations. Strong recommendations are made for adalimumab, bimekizumab, infliximab, secukinumab, and routine pain assessment. Conditional recommendations are made for topical clindamycin, resorcinol, and ruxolitinib; oral doxycycline, tetracycline, and clindamycin with rifampin; intravenous ertapenem; spironolactone; short-term systemic corticosteroids; upadacitinib; specific procedural interventions; tobacco cessation; supportive pain management; and zinc supplementation and vitamin D repletion.

LIMITATIONS: Analysis is limited to best evidence available from systematic review.

CONCLUSIONS

These guidelines provide evidence-based recommendations for the management of hidradenitis suppurativa.