In Office Procedural Management of Hidradenitis Suppurativa

The presentation addresses the in-office procedural management of Hidradenitis Suppurativa (HS), outlining effective strategies to enhance patient care. The speaker emphasizes the importance of combining medical and procedural treatments to improve outcomes for patients experiencing HS. Several case studies are used to illustrate various procedural options. For example, laser hair removal is noted as beneficial for patients with early-stage HS, particularly in reducing flare-ups related to shaving and sweating, with the 1064 ND YAG laser showing the most promising results. Botulinum toxin is also discussed as a viable option for managing hyperhidrosis and overall symptom relief. The speaker introduces intralesional triamcinolone (ILTAC) for treating inflamed nodules and abscesses, highlighting its rapid effectiveness in pain reduction. The need for incision and drainage is acknowledged for painful abscesses, although the recurrence rate can be high. Surgical de-roofing is suggested for recurrent lesions that have not responded to medical therapy, with lower recurrence rates compared to standard excisions. Lastly, the presentation reassures healthcare providers that they can perform these procedures successfully in their offices with minimal equipment and that patient satisfaction remains high.