Management of Hidradenitis Suppurativa in the United Arab Emirates (UAE): A Consensus Statement from the Emirates Dermatology Society.

Abstract

<h4>Introduction</h4>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting the pilosebaceous unit and is linked to several comorbid disorders as well as an economic impact burden. Variations in clinical presentation, comorbidities and healthcare delivery across regions necessitate localised guidelines. This consensus aims to provide evidence-based, expert-driven recommendations tailored to the United Arab Emirates (UAE) healthcare context to standardise and improve HS management.<h4>Methods</h4>A three-phase modified Delphi methodology was employed to develop consensus statements among 14 experts based in the UAE. A comprehensive literature review informed the development of 61 draft statements covering diagnosis, classification, comorbidities, treatment and multidisciplinary care. Statements achieving ≥ 80% agreement in two rounds of voting were included. Final recommendations reflect expert consensus and current best evidence.<h4>Results</h4>A total of 58 consensus statements were adopted. Key recommendations address clinical diagnosis on the basis of lesion type and anatomical location, the use of Hurley staging and International Hidradenitis Suppurativa Severity Score System (IHS4) for severity assessment, and the need for screening for metabolic and inflammatory comorbidities. Treatment guidance includes lifestyle modifications, the use of topical and systemic antibiotics, hormonal therapy, biologics and surgical options, based on disease severity. Supportive care, including pain management, psychological support and multidisciplinary coordination, was emphasized. A management algorithm was developed for practical application.<h4>Conclusions</h4>This consensus provides the first UAE-specific guidelines for HS diagnosis and management. It supports a comprehensive, stepwise and multidisciplinary approach to reduce disease burden and improve patient outcomes. Adoption of these recommendations is expected to harmonise clinical practice and foster improved quality of care for patients with HS in the UAE.