The Hospitalist’s Toolbox: Inpatient Management of Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic dermatologic condition characterized by painful inflammatory nodules, abscesses, and draining sinus tracts, predominantly affecting intertriginous regions and significantly impairing patients' quality of life. These lesions are prone to relapsing, with many patients experiencing painful recurring flares. HS patients frequently visit emergency departments during flares and often end up requiring hospitalization. This may be due to limited access to outpatient dermatologic care. Therefore, hospitalists must possess the knowledge and skills to effectively manage HS flares in the inpatient setting. Optimal management of HS involves a multimodal approach, including wound care, topical and systemic medications, and pain management. While systemic antibiotics are frequently used for their antiinflammatory effects, their selection is controversial due to concerns about resistance. This article provides an approach to HS in the acute setting.