Discussing Raising HS Awareness and Treatments, With Kiera Booth, MD

As Hidradenitis Suppurativa (HS) Awareness Week highlights the burden of the chronic inflammatory skin disease, Kiera Booth, MD, a board-certified dermatologist with Premier Dermatology and Cosmetic Surgery in Delaware, highlighted clinicians’ greater number of tools than ever to improve outcomes for individuals living with moderate-to-severe HS.1,2

In this new interview with HCPLive, Booth noted treatment selection begins with understanding a patient's goals and disease burden. While some individuals experience severe but infrequent flares, others contend with frequent lesions that significantly impact quality of life. Tailoring treatment to these experiences remains a critical part of care.

Booth highlighted the evolution of the HS treatment landscape in recent years, particularly with the arrival of newer biologic agents. These additions have expanded therapeutic options and enabled dermatologists to help more patients attain meaningful levels of disease control. Looking ahead, she anticipates even greater progress as multiple investigational therapies continue through clinical development.

Beyond pharmacologic treatment, Booth highlighted the growing role of procedural interventions such as deroofing. She described the technique as highly impactful for patients with chronic tunnels and recurrent lesions, particularly those who have experienced delays in diagnosis. Compared with some older surgical approaches, deroofing may reduce the likelihood of recurrence while addressing areas of persistent disease.

Delayed diagnosis remains one of the most significant challenges in HS care, according to Booth. Many patients initially seek treatment in emergency departments, where acute flares may be addressed without establishing long-term disease management. Delays can also occur when patients hesitate to begin systemic therapies. Booth stressed the importance of controlling inflammation early, noting that prolonged disease activity can lead to permanent scarring, tunnels, and other structural skin changes.

Although therapeutic options continue to expand, Booth acknowledged that unmet needs remain. Not every patient responds adequately to currently available treatments, and comorbidities such as Crohn’s disease or ulcerative colitis can limit the use of certain therapies.

Among emerging treatments, Booth identified Janus kinase (JAK) inhibitors as one of the most promising developments. She said oral JAK therapies could offer potent anti-inflammatory effects while potentially benefiting patients with multiple inflammatory conditions. Booth also encouraged clinicians to familiarize themselves with evolving safety data surrounding JAK inhibitors so they can confidently discuss risks and benefits with patients.

For HS Awareness Week, Booth hopes clinicians feel empowered to engage with HS care. She emphasized that today's therapeutic landscape is dramatically different from a decade ago, with safe and effective options capable of producing meaningful improvements in patients' lives.

Booth had no disclosures of note to highlight.

References

1. Krueger JG, Frew J, Wolk K, et al. Hidradenitis suppurativa: new insights into disease mechanisms and an evolving treatment landscape. Br J Dermatol. 2024 Jan 23;190(2):149-162. doi: 10.1093/bjd/ljad345. PMID: 37715694.

2. Ribero S, Dapavo P, Casalegno C; HS Awareness Working Group. Improving the disease awareness: how a communication campaign brings hidradenitis suppurativa to the light. J Eur Acad Dermatol Venereol. 2019 Oct;33 Suppl 6:7-9. doi: 10.1111/jdv.15828. PMID: 31535765.