An Assessment of Clinician Knowledge of Hidradenitis Suppurativa: Insights from a Multidisciplinary Survey Study

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, debilitating skin disease primarily diagnosed through clinical examination. Despite its characteristic clinical features, HS remains under-recognized and frequently misclassified, especially by non-dermatologist clinicians. This study aims to evaluate the diagnostic accuracy of HS across various specialties, identify knowledge gaps, and inform targeted educational strategies to reduce diagnostic delays. Methods: A cross-sectional survey was conducted during multidisciplinary scientific conferences, enrolling 655 clinicians including dermatologists, gynecologists, urologists, general surgeons, and general practitioners. Participants were presented with clinical images representing HS lesions at Hurley stages I-III and responded to open-ended and closed-ended diagnostic questions. Data were analyzed to assess diagnostic accuracy and compare recognition patterns across specialties. Results: The recognition of HS varied significantly by specialty and disease stage. For Hurley stage III axillary disease, correct identification was highest among dermatologists (96.56%) compared to general practitioners (48.91%), gynecologists (31.25%), urologists (40%), and general surgeons (63.64%). In a Hurley II genital case in a male patient, only 34.5% diagnosed HS, while 25.65% suggested furunculosis and 16.18% venereal granuloma. For a Hurley I genital case in a female patient, 29.92% diagnosed HS, with furunculosis (23.36%) and steatocystoma multiplex (14.35%) as common misdiagnoses. A Hurley III buttock case was correctly identified by only 29.77% of participants. Conclusions: This large, first-of-its-kind global survey highlights substantial gaps in HS recognition, particularly among non-dermatologist clinicians. The findings underscore the urgent need for targeted, multidisciplinary educational interventions to improve diagnostic accuracy, reduce delays, and ultimately enhance patient outcomes in HS.