Navigating Hidradenitis Suppurativa with A/Prof Erin McMenimen on The Good GP

In this episode, host Dr Krystyna de Lange welcomes Associate Professor Erin McMenimen, a clinical dermatologist with appointments at the University of Queensland Medical School and Princess Alexandra Hospital, to discuss Hidradenitis Suppurativa (HS).

Defining HS as a chronic auto-inflammatory condition, highlighting its similarities to inflammatory bowel disease and psoriasis. A/Prof McMenimen explains the disease's pathophysiology, noting that inflammation starts in the hair follicles and leads to scarring and sinus tract formation. Key associated factors are smoking, obesity, family history, and secondary infections.

They then shift to the signs and symptoms of HS, emphasising the importance of early recognition by GPs. A/Prof McMenimen outlines the diagnostic criteria, focusing on abscesses and boils in body folds and the significance of multiple episodes over time.

She also explains the Hurley staging system used to assess HS severity and describes the impact of HS on patients' quality of life, including pain, mental health issues such as depression and anxiety, and social isolation.

On the topic of management, They covered lifestyle interventions, including avoiding heat and friction, dietary adjustments, and smoking cessation strategies, followed by stepwise medical treatments like antiseptic washes, topical and oral antibiotics, and anti-androgen therapy. She also discusses advanced treatments for severe cases, including intralesional steroids, de-roofing surgery, and biologics like adalimumab and secukinumab.

A/Prof McMenimen underscores the importance of early referral to dermatologists for effective management and better patient outcomes, advocating for a multidisciplinary approach to care.

Links and Resources:

• Dermnet page on HS: https://dermnetnz.org/topics/hidradenitis-suppurativa
• UQ Dermatology Research Centre page on HS: https://dermatology-research.centre.uq.edu.au/research/hidradenitis-suppurativa
• HS Patient Brochure: https://dermatology-research.centre.uq.edu.au/files/1915/HS-patient-education-and-treatment-guide-pamphlet.pdf

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