In this episode, guest Lauren Orenstein, MD, MSc, discusses the challenge of diagnosing hidradenitis suppurativa, the range of therapies and pain management for patients.

· Intro 0:28

· Lauren Orenstein, MD, MSc 0:37

· What is HS, and how is it diagnosed? 0:57

· Is there a differential diagnosis? 2:11

· Who develops HS, and why does it develop? 3:16

· Are there biological explanations for this patient distribution in the US? 3:54

· Are there any underlying genetic or environmental factors contributing to the prevalence of HS by race in the US? 4:50

· How much of an impact do hormones have on diagnosis? 5:37

· What role does age play in diagnosis? 6:45

· Tell us about your approach to this disease. 9:30

· Are retinoids like acitretin commonly used? 11:39

· How do you choose which biologic therapy to use for management of HS? 12:25

· Are there striking differences in findings between different biologics? 14:50

· Can you explain what deroofing is and when a patient should undergo this procedure? 15:25

· How do you do this procedure clinically in your practice? 19:17

· How do you manage the pain aspect of HS? 20:31

· Do people have rebounds coming off prednisone? 23:57

· What about patients with chronic pain? 24:46

· Thanks for listening. 28:11

Lauren Orenstein, MD, MSc, is an assistant professor in the department of dermatology at Emory University and staff physician at Grady Memorial Hospital. We’d love to hear from you! Send your comments/questions to Dr. Gelfand at [email protected]. Follow Dr. Gelfand on LinkedIn. Dr. Orenstein can be reached at [email protected]. For more, be sure to visit the Beneath the Surface video blog on Healio.com. Disclosures: Gelfand is Chief Medical Editor of Healio Dermatology. Orenstein reports financial relationships with Incyte, Novartis, Pfizer and UCB Pharma and is a member of the board of directors for the HS Foundation.