Shorter time to initiation of biologic therapy in the setting of a hidradenitis suppurativa specialty clinic.

Hidradenitis suppurativa (HS) is a chronic condition with a significant psychological and physical burden but a paucity of effective treatments. Early intervention with adalimumab improves disease outcomes. Two previous studies in Denmark and Northern Ireland have identified an 8.2 and 2.9 year time from first HS systemic/dermatology consultation to commencing a biologic. We aimed to evaluate the time from disease onset and from first speciality HS clinic review to the initiation of biologic therapy. We reviewed, retrospectively, 34 patients on biologic treatment for HS. The mean diagnostic delay was 12.4 years. The mean time from disease onset to biologic initiation was 14.8 years. Prior to a biologic, patients received a median 3.3 treatments from the specialty HS clinic. The median time to biologic from first presentation at the specialty HS clinic was 1 year. This is shorter than the therapeutic delay reported in dermatology clinics in Denmark and Northern Ireland providing evidence on the importance of specialised HS treatment. However, to make an impact with specialised HS care and earlier biologics, diagnostic delay needs to be reduced.