North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations.

Background: Hidradenitis suppurativa (HS) affects different patient populations that require unique considerations in their management. However, no HS guidelines for these populations exist.
Objective: To provide evidence-based consensus recommendations for patients with HS in 7 special patient populations: (i) pregnancy, (ii) breastfeeding, (iii) pediatrics, (iv) malignancy, (v) tuberculosis infection, (vi) hepatitis B or C infection, and (vii) HIV disease.
Methods: Recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation system to ascertain level of evidence and selected through a modified Delphi consensus process.
Results: One hundred nineteen expert consensus statements are provided for the management of patients with HS across these 7 special patient populations.
Competing Interests: Conflicts of interest Dr Alhusayen has received personal fees from Abbvie, Bausch health, Boehringer Ingelheim, Fresenius kabi, Janssen, Novartis, Pfizer, Sandoz, and UCB; investigator fees from Abbvie, Bausch health, Incyte, and Janssen outside the submitted work. Dr Alavi has served as a board member of HSF; consulted and received institutional fees for Admirall, BI, Incyte, InflarX, leo, Novartis, UCB; received principal investigator fees for BI and Processa. Dr Alikhan has been on an advisory board for Novartis. Dr Aleshin has received consulting fees from Santa Ana Bio and Abbvie; served on advisory board for Novartis; received research funding from UCB. Dr Bahashwan has received honoraria from Janssen. Dr Daveluy has been a speaker, researcher, and consultant for Abbvie, UCB, Novartis; Researcher: Pfizer, Sanofi, and Regeneron. Dr Goldfarb has participated in clinical trials with Abbvie, Pfizer, Chemocentryx, and Incyte and served on advisory boards and consulted for Novartis, Boehringer Ingelheim and Sonoma Biotherapeutics; receives research support from Novartis and DeepX Health. Dr Garg is an advisor for AbbVie, Boehringer Ingelheim, Incyte, Insmed, Novartis, Pfizer, Sonoma Biotherapeutics, UCB, Union Therapeutics, and receives honoraria. Dr Gulliver has received grants/research support from AbbVie, Amgen, Eli Lilly, Novartis, and Pfizer; received honoraria for ad boards/invited talks/consultation from AbbVie, Actelion, Amgen, Arylide, Bausch Health, Boehringer, Celgene, Cipher, Eli Lilly, Galderma, Janssen, LEO Pharma, Merck, Novartis, PeerVoice, Pfizer, Sanofi-Genzyme, Tribute, UCB, Sun Pharma, and Valeant; has received clinical trial study fees from AbbVie, Asana Biosciences, Astellas, Boerhinger-Ingleheim, Celgene, Corrona/National Psoriasis Foundation, Devonian, Eli Lilly, Galapagos, Galderma, Janssen, LEO Pharma, Novartis, Pfizer, Regeneron, Sun Pharma, and UCB. Dr Jaleel is an investigator for UCB and Eli Lilly; reports consulting for Eli Lilly and Chemocentryx and receives honoraria; has received funds from Pfizer and UCB for research fellow support; received funds from Dermatology Foundation, Skin of Color Society, Duke Strong Start Physician Scientist Award, and NIH K12; and is a board member for Skin of Color Society. Dr B. Kimball has received honoraria or consulting fees from Abbvie, Alumis, Bayer, Boehringer Ingelheim, Eli Lilly, Evoimmune, Innovaderm, Janssen, Novartis, Moonlake, Pfizer, Priovant, Sanofi, Sonoma Bio, Target RWE, UCB, Union Therapeutics; is on the board of directors of Almirall. Instution has received grants from Abbvie, Admirx, Anapyts Bio, Aristea, Bristol Myers Squibb, Eli Lilly, Incyte, Janssen, Moonlake, Novartis, Pfizer, Prometheus, Sanofi, Sonoma Bio, and UCB. Dr G. Kirchhof has received advisory board/consulting fees from AbbVie, Amgen, Arcutis, Bausch, Eli Lilly, Incyte, Janssen, LEO Pharma, Novartis, Pfizer, Recordati, Sanofi-Genzyme, Therakos, UCB Biopharma; speaker's bureau/honoraria from AbbVie, Amgen, Arcutis, Bausch, Eli Lilly, Incyte, Janssen, LEO Pharma, Novartis, Pfizer, Recordati, Sanofi-Genzyme, and UCB. Dr Kirby is an employee of Incyte Corporation; is on the advisory board for AbbVie, Incyte, Novartis, UCB; is a consultant for AbbVie, Alumis, DermTech, Guidepoint, Incyte, Insmed, Janssen, Moonlake, Novartis, and UCB. Dr Lev-Tov is a founder, owns stock, and has a podcast for Learnskin.com; has consulted for Insmed, NextScience, Novartis, Pfizer, UCB, and Vomaris; is a clinical trialist for Incyte, Medline, Molnlyke, Moonlake, Novartis, Pfizer, Sigvaris, Tissue Tech, and UCB; receives research grant support from Essity, Next Science, Sigvaris, and Vomaris. Dr A. Lowes has served on the advisory boards for Abbvie, InflaRx, Janssen, Novartis, UCB, Viela Bio; consulted for Almirall, BSN medical, Incyte, Janssen, Kymera, Phoenicis, and XBiotech. Dr Lara-Corrales has received grants/research support from Abbvie, Clementia, Eli Lilly, Timber, Arcutis, EB Medical Research Foundation, EB Research Partnership, Physicians Services Incorporated (PSI) Foundation, SkIN Canada, La Roche Posse, Sanofi Genzyme, Regeneron, Mayne Pharma, Brystol Myers, and Alexion; has received honoraria or consultation fees from Sanofi Genzyme, Abeona, Avicanna, Ipsen, Novartis, Eli Lilly, Union Chimique Belge's (UCB) and Abbvie; participated in company sponsored speaker's bureau for Sanofi Genzyme, Abbvie, Eli Lilly, Novartis, Alexion; is a board member of DeBRA Canada, Camp Liberte and Children International Summer Villages (CISV). Dr Micheletti has received consulting fees from Vertex and research funding from Acelyrin, Amgen, Boehringer-Ingelheim, Cabaletta Bio, and InflaRx, all outside the submitted work; he is also a Section Editor for JAMA Dermatology. Dr Okun has consulted for AbbVie, Azora Therapeutics, Bluefin Biomedicine, Boehringer Ingelheim, Incyte, Novartis, Phoenicis, Regeneron, and Vyne Therapeutics. Dr Orenstein has received consulting fees from UCB and Novartis; has received grant support from Pfizer; is an Associate Editor for Dermatology; is a board member of the Hidradenitis Suppurativa Foundation. Dr Poelman has received grant support from UCB, Pfizer, Amgen; consulting fees from Abbvie, Novartis, UCB, Sandoz, Bausch health, Incyte, Janssen; is an investigator for clinical trials for Abbvie, Incyte, Moonlake, BioJamp; is president of the Canadian Hidradenitis Suppurativa Foundation. Dr Piguet has received grants from AbbVie, Bausch Health, Celgene, Eli Lilly, Incyte, Janssen, LEO Pharma, L'Oréal, Novartis, Organon, Pfizer, Sandoz, Sanofi, and Bristol Myers Squibb; received payment or honoraria for speaking engagement from Sanofi; participated on an advisory board for LEO Pharma, Novartis, Sanofi, and Union Therapeutics; received equipment donation from L'Oréal. Dr Porter has received consulting fees from Novartis, Janssen, UCB, Pfizer, Trifecta Clinical, Alumis, Incyte, Abbvie, Eli Lilly, Sanofi, Sonoma Biotherapeutics, and Prometheus Laboratories; her institution has received grants from Anaptysbio, Novartis, UCB, Pfizer, Janssen Pharmaceuticals, Abbvie, Incyte, Eli Lilly, Regeneron, Moonlake Therapeutics, Sonoma Biotherapeutics, Sanofi, Bristol-Myers-Squibb, Oasis Pharmaceuitcals, Bayer, and Prometheus Laboratories. Dr Resnik: Speaker's Bureau, Abbvie, Novartis. Board member, Hidradenitis Suppurativa Foundation. Dr Sibbald has received honoraria from Abbvie, Leo Pharma, Novartis, Incyte, Pfizer, and Sanofi; grant support from Pfizer. Dr Shi is on the board of directors for the Hidradenitis Suppurativa Foundation (HSF); is an advisor for the National Eczema Association; is a stock shareholder of Learn Health; has served as an advisory board member, investigator, speaker, and/or received research funding from Sanofi Genzyme, Regeneron, AbbVie, Genentech, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Incyte, Boehringer Ingelheim, Almirall, Alumis, Aristea Therapeutics, Menlo Therapeutics, Dermira, Burt's Bees, Galderma, Kiniksa, UCB, Bain Capital, Target-PharmaSolutions, Altus Lab/cQuell, MYOR, Polyfins Technology, GpSkin and Skin Actives Scientific. Dr Sayed is an investigator for AbbVie, ChemoCentryx, Incyte, InflaRx, Novartis and UCB Pharma; has received consultancy fees from AbbVie, Alumis, Astrazeneca, InflaRx, Sandoz, Incyte, Logical Images, Sanofi, Sonoma Biotherapeutics, and UCB Pharma; is a speaker for AbbVie and Novartis; is the secretary of the HS Foundation and member of the European HS Foundation. Dr Wong is a consultant for Abbvie, Amgen, Bausch Health, BioJamp, Boehringer Ingelheim, Bristol Meyers Squibb, Celltrion, Eli-Lilly, Galderma, Janssen, Johnson & Johnson, Leo Pharma, Novartis, Pfizer, Sanofi, Sun Pharma, and UCB; has received speaker fees from Abbvie, Eli-Lilly, Leo Pharma, Novartis, Pfizer and UCB; is a board member for the Canadian HS Foundation. Dr Zaenglein has received research grants from Abbvie, Galderma, Dermavant, Incyte, Palvella; has received consulting fees from UCB, Ortho Dermatologics, and Dermavant; is an Editor-in-Chief of Pediatric Dermatology. Dr Veillette has received honoraria for presentations for AbbVie, BioJAMP, Celltrion, Janssen, Novartis, Sanofi, Bausch Health, Pfizer, Boehringer-Ingelheim, Incyte, and UCB; has received consulting fees from Abbvie, Bausch Health, BioJAMP, Celltrion, Eli Lilly, Galderma, LEO Pharma, Janssen, Novartis, Sandoz, Pfizer, Sanofi, Sun Pharma, UCB, and Boehringer-Ingelheim; is an investigator for Sanofi, AnaptysBio, Boehringer-Ingelheim, Abbvie, Amgen, Bausch, Merck, Pfizer, and Incyte; is a board member of the Canadian HS Foundation. Dr L. Hsiao is on the Board of Directors for the Hidradenitis Suppurativa Foundation; has consulted for AbbVie, Aclaris, Boehringer Ingelheim, Incyte, Novartis, and UCB; is a speaker for AbbVie, Novartis, Sanofi Regeneron, UCB; is an investigator for Amgen, Boehringer Ingelheim, and Incyte. Dr B. Naik has received grant support from AbbVie; received consulting fees from 23andme, Abbvie, Aristea Therapeutics, Nimbus Therapeutics, Medscape, Sonoma Biotherapeutics, DAVA Oncology, Boehringer Ingelheim, UCB, and Novartis; received investigator fees from Pfizer; holds shares in Radera, Inc; is an Associate Editor for JAMA Dermatology and a board member of the Hidradenitis Suppurativa Foundation. Drs Lenczowski, Lam, and Author Dienes have no conflicts of interest to declare.
(Copyright © 2025 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)