Challenges of making an accurate and timely diagnosis of hidradenitis suppurativa

Hidradenitis suppurativa diagnosis is a clinical diagnosis based on typical lesions in typical locations, such as the axilla, groin and buttocks, along with a pattern of chronicity, Porter said. Milder disease is often missed because clinicians look for late-stage changes such as tunnels and rope-like scars, Porter said. A telltale sign of hidradenitis suppurativa, Porter said, is acne-like lesions in places where people don’t get acne, such as the armpits, groin, thighs and buttocks, that recur more than once in a six-month period. She added that approximately 30% to 40% of patients have a family history of hidradenitis suppurativa, so asking about affected relatives can help with diagnosis.