Spanish Clinical Management Guideline for Hidradenitis Suppurativa. Part I: Pathogenesis, Diagnosis, and Disease Staging

Hidradenitis suppurativa is a chronic inflammatory disease that typically presents with nodules, abscesses, tunnels, and scars in areas rich in pilosebaceous units, such as the axillae and the inguinal and anogenital regions. It is a condition with a high potential for progression, characterized by inflammation and pain, and has a significant psychological and social impact, markedly affecting quality of life. In addition, it is an underdiagnosed disease with a considerable diagnostic delay, which may lead to disabling situations.Therapeutic management is complex because it must be adapted to the clinical presentation and severity of the disease and often involves associated comorbidities. However, early management of the disease can prevent the progression of structural damage and improve both prognosis and patient quality of life.This article reviews the latest findings regarding the etiopathogenesis of the disease, diagnosis, and phenotyping models that assist in decision-making for disease management.