The Secret Scourge

Some diseases have a greater impact than others. Hidradenitis suppurativa (HS) is a high-impact disease, not only due to its signs and symptoms but also because of the psychosocial connotations of the predominant signs. Most patients primarily associate HS with its inflamed lesions, which they commonly describe as boils. Boils are a culturally laden concept that elicits associations to something unclean and contagious in most people, making HS a very stigmatizing disease. While it is therefore lucky that HS lesions usually remain hidden, other inherent features of HS contribute to the plight of patients. In particular, the risk of sudden malodourous discharge and pain burden the patients. The diagnosis of HS is furthermore associated with a significant delay, indicating that there is a substantial group of patients with an unmet need of both diagnosis and subsequent treatment globally.

The literature on HS is growing rapidly, and this issue of Dermatologic Clinics is therefore an important milestone. It brings together an eminent group of interested specialists with a long and proven history of expertise in the area of HS to provide the reader with both evidence and an updated expert appraisal. The authors cover many important aspects of HS, sometimes challenging our understanding of the pathogenesis of the disease, sometimes providing guidance to treatment and management of the many patients that are making their presence felt in clinics all over the world.

It is therefore my hope that this issue will help promote three important aspects of HS: one clinical, one academic, and one professional. First and foremost, it is intended to aid the many colleagues who are treating these patients all over the world in the practical management of the disease. Patients have an unmet need for diagnosis and treatment, which I hope this issue will help alleviate. Second, one may hope that the reviews of possible causes and pathogenesis may inspire more people to get involved in the exploration of this complex disease and strengthen the academic interest. Academic interest not only helps us meet current challenges but also provides a better understanding of the complex mechanisms that may also be involved in other diseases, providing new insights and more solutions in the future. Finally, this issue is a professional statement, reminding us all that skin diseases are not merely cosmetic problems.

I would like to thank the authors for their generous and enthusiastic contributions to this issue; may many patients derive benefit from these texts.

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