Unraveling the Genetic Threads of Hidradenitis Suppurativa: Diagnosis and Treatment Implications

HS management is shifting in real time as genetic findings begin to inform risk stratification and treatment selection, with clinicians weighing how polygenic signals and variant patterns should shape care today while formal validation continues.

Genetic variants play a significant role in HS, influencing disease susceptibility and response to treatments; evidence from a recent analysis links variant patterns to prognosis and therapeutic outcomes, motivating more precise, genotype-aware care pathways.

Beyond susceptibility, variant patterns may also relate to treatment response, linking diagnosis and intervention. Recent work has highlighted multiple genetic markers and the emergence of polygenic signatures in HS; another study specifically describes a polygenic signal in sporadic disease, while separate familial cases have been associated with monogenic variants.

For clinicians, the practical question is how to fold these findings into everyday decision-making without overpromising. At present, genetics can frame conversations about heterogeneity and prognosis, but they should be presented alongside clinical severity, comorbidities, and patient preferences as part of shared decision-making.