When is it appropriate to refer a patient with hidradenitis suppurativa to a specialist for further evaluation and treatment?

Referral to a specialist for hidradenitis suppurativa (HS) is appropriate when:

• There is diagnostic uncertainty about the condition.
• The disease is moderate to severe or not responding to optimal primary care management.
• The patient has significant scarring, sinus tract formation, or complex lesions requiring advanced interventions.
• There is significant psychological distress or impact on quality of life related to HS.
• Specialist treatments such as systemic therapies, biologics, or surgical options are being considered.

In these cases, referral to a dermatologist or a multidisciplinary team experienced in managing HS is recommended for further evaluation and management.