Hidradenitis Suppurativa: Why Surgery’s Role is Evolving—And It’s Not What You Think
At the 10th Annual Symposium on Hidradenitis Suppurativa Advances (SHSA), a groundbreaking shift in the treatment landscape was highlighted by Ralph George, MD, FRCS. Contrary to popular belief, the improving outcomes in HS surgery aren’t solely due to surgical advancements—they’re a result of collaboration. But here’s where it gets controversial: could this interdisciplinary approach eventually make surgery less necessary for HS patients? Let’s dive in.
During his presentation, “Procedural Interventions Across the Spectrum of HS,” George, an associate professor and director of the CPD Department of Surgery at the University of Toronto, emphasized that the synergy between medical and surgical treatments is transforming how HS is managed. This isn’t just about cutting-edge procedures; it’s about how systemic therapies are paving the way for surgery to be more effective than ever before. “The real benefit has been the collaboration,” George noted, challenging the traditional view of surgery as a last resort.
And this is the part most people miss: Surgery isn’t just for severe, end-stage HS cases. George explained that even patients with mild, localized disease can benefit from surgical intervention, potentially avoiding lengthy treatments. “It’s something that can be used across the spectrum of hidradenitis suppurativa,” he said, dispelling the myth that surgery is only for the worst scenarios.
When asked about recent advancements, George highlighted the rapid pace of research in HS. “It’s hard to keep up,” he admitted, pointing to bench research and clinical trials as the driving forces behind improved surgical outcomes. This raises a thought-provoking question: If medical treatments continue to advance, could surgery eventually become less central to HS care, much like it has in breast cancer?
The SHSA meeting itself stands out as a model for interdisciplinary collaboration. Unlike typical disease-specific conferences, SHSA brings together molecular biologists, patients, surgeons, and dermatologists in a unique, participant-driven environment. “We’re all better from each other,” George observed, advocating for more meetings that foster such diverse interactions.
In closing, George acknowledged that while significant progress has been made, there’s still a long way to go in HS treatment. “I don’t mind if the advances put me out of business,” he said boldly, inviting a controversial interpretation: Is the ultimate goal of HS research to make surgery obsolete? What do you think? Share your thoughts in the comments—let’s spark a conversation about the future of HS care.
