Patient: [Patient Name] MRN: [Medical Record Number] Date: [Date of Visit]
Chief Complaint: Briefly describe the patient’s main reason for this visit. This could include:
New or worsening flares of HS lesions (pain, tenderness, drainage)
Scarring or itching at old HS sites
Functional limitations due to HS (difficulty sitting, walking)
Emotional distress related to HS
History of Present Illness:
Age at HS diagnosis
Current disease severity (Hurley staging system can be referenced)
Location and number of involved sites (axillae, groin, buttocks, etc.)
Frequency and duration of flares
Drainage characteristics (purulent, bloody)
Any recent changes in symptoms or triggering factors (stress, sweating)
Past Medical History:
Comorbid conditions (obesity, polycystic ovary syndrome, smoking)
Prior treatments for HS (topical medications, antibiotics, injections, surgery)
Medications (prescription and over-the-counter)
Allergies (especially to medications used for HS)
Family History:
History of HS in first-degree relatives
Social History:
Smoking status (smoking cessation is highly encouraged)
Weight (may be a contributing factor)
Occupation (activities that exacerbate friction)
Physical Examination:
General appearance (signs of infection, emotional distress)
Skin exam:
Location and characteristics of HS lesions (inflamed nodules, abscesses, sinus tracts)
Scarring or pigmentation at old lesions
Assessment of pain and tenderness
Lymphadenopathy (swollen lymph nodes)
Laboratory Tests:
Complete blood count (CBC) – elevated white blood cells may indicate infection
Swab culture (if abscess present) to identify causative bacteria
Imaging Studies:
Ultrasound (may be helpful to assess abscesses or sinus tracts)
Diagnosis:
Hidradenitis suppurativa (Hurley stage can be specified)
Treatment Plan:
Topical medications (antibiotics, retinoids)
Oral antibiotics (for flares or widespread disease)
Hormonal therapy (anti-androgens for women with hormonal triggers)
Corticosteroid injections (for acute flares)
Surgery (for severe, unresponsive cases)
Weight management (if overweight or obese)
Smoking cessation
Prognosis:
HS is a chronic condition with flares and remissions
Discuss the importance of long-term management to control symptoms
Patient Education:
Explain HS and its chronic nature
Importance of good hygiene practices
Management strategies to reduce flares (wearing loose clothing, managing weight)
Stress management techniques
Support groups and resources available for HS patients
Warning signs of infection (worsening pain, fever)
Next Follow-up:
Schedule for the next appointment to monitor response to treatment and address any ongoing symptoms