Imagine battling a relentless skin condition that can disrupt lives across various stages of severity – but what if innovative teamwork between medical treatments and surgical procedures held the key to better outcomes for patients with Hidradenitis Suppurativa? That's the exciting promise emerging from recent discussions in the dermatology world, and it's sparking conversations about how collaboration is revolutionizing care. Let's dive into the insights shared at the 10th Annual Symposium on Hidradenitis Suppurativa Advances, where experts highlighted how blending medical and surgical approaches is transforming treatment strategies for this challenging disease.
At this year's event, hosted by the Hidradenitis Suppurativa Foundation and held online at https://shsa.joynsymposium.com/conference/, Ralph George, MD, FRCS, took center stage with his presentation titled “Procedural Interventions Across the Spectrum of HS.” As an associate professor and director of the CPD Department of Surgery at the University of Toronto, an executive board member of the Canadian Hidradenitis Suppurativa Foundation, and the medical director of the CIBC Breast Centre in Toronto, Dr. George brought a wealth of experience from his background as a surgical oncologist. In a chat with Dermatology Times, he reflected on the highlights from his session and the broader benefits of attending the 2025 HSHA meeting, painting a picture of optimism for those affected by HS.
But here's where it gets controversial: Could surgery really become less essential in the future, potentially even putting some surgeons out of work? Dr. George tackled this head-on in his answers to key questions, emphasizing that the synergy between different treatment modalities is what's driving real progress.
When asked about the primary message from his talk, Dr. George explained that, as a surgical oncologist, he's witnessing surgery becoming increasingly effective for HS – not solely due to advancements in surgical techniques themselves, but because complementary medical treatments are paving the way. These non-surgical options, like medications and lifestyle adjustments, are helping manage the disease more comprehensively, allowing surgical interventions to deliver even greater results. He stressed that the true game-changer has been this collaborative spirit among healthcare providers. For beginners new to HS, think of it like this: Imagine trying to fix a leaky roof by only patching one spot – it might work temporarily, but combining patches with better drainage systems (medical treatments) creates a stronger, longer-lasting solution.
Digging deeper into pearls of wisdom from his session, Dr. George addressed a common patient concern: Many individuals with HS dislike the idea of surgery or view it as a last resort, and he's quick to reassure that it's not always required. That said, surgery can offer significant relief at nearly every stage of the condition. For example, a patient with mild, localized HS might opt for a minor procedure instead of enduring prolonged medical regimens, such as extended courses of antibiotics or anti-inflammatory drugs. This flexibility means surgical options are versatile tools applicable throughout the HS spectrum – not reserved only for severe, widespread cases. To illustrate, picture someone with a small, persistent boil that doesn't respond to creams; a targeted surgical removal could prevent it from worsening, saving time and discomfort compared to broader treatments. And this is the part most people miss: Surgery isn't just for 'extreme' situations; it can be a smart, early intervention for localized mild disease, challenging the notion that it's always an invasive last-ditch effort.
On the topic of emerging research, Dr. George expressed enthusiasm about the rapid advancements in HS management, noting how the field is evolving so quickly it's tough to stay current. While surgical techniques have been established for decades, he credits the excitement to breakthroughs in basic science and clinical studies. For instance, new studies on biologics (medications that target the immune system) or genetic factors are providing surgeons with better insights, enabling more precise and effective procedures. This interdisciplinary progress is empowering surgeons to tailor interventions more accurately, leading to improved patient outcomes. Beginners, imagine HS as a puzzle where each piece (from lab discoveries to patient care) fits together to reveal a clearer picture – and right now, more pieces are being discovered than ever.
Dr. George also underscored the uniqueness of disease-specific gatherings like the SHSA, where diverse experts come together in ways that general medical conferences often don't. Unlike meetings focused on specific surgeon types or specialties, this event fosters an inclusive environment – perhaps a molecular biologist brainstorming with a surgeon, a dermatologist advising a patient, or vice versa. He described it as a vibrant exchange that enriches everyone involved, making it regrettable that more conferences don't adopt this model. To put it simply, it's like a family reunion where doctors from different 'branches' share stories and strategies, leading to innovative ideas that benefit all.
In his final thoughts on HS, Dr. George reflected on the journey ahead, comparing it to breast cancer where surgical roles are diminishing thanks to effective non-surgical therapies. He hopes for a similar trajectory in HS, where advancements might reduce the need for surgery, even if it means fewer procedures for professionals like him. It's a bold vision: prioritizing patient quality of life over traditional methods. But here's where you might disagree – is it realistic to hope for a world where surgery plays a smaller role in HS, potentially disrupting careers in the process? Or does this overlook the irreplaceable value of skilled surgical interventions? I'd love to hear your thoughts: Do you see collaboration as the ultimate solution, or are there risks to downplaying surgical options? Share your opinions in the comments below – let's keep the conversation going!
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