Dr Haley Naik: Improved Medical Education Can Help Reduce Diagnostic Delays of HS

Some populations face longer diagnostic delays for hidradenitis suppurativa (HS), but medical education can help improve knowledge of common dermatologic diseases and reduce delays in diagnosis, said Haley Naik, MD, FAAD, associate professor of dermatology, University of California, San Francisco, School of Medicine.

Transcript

Diagnosing hidradenitis suppurativa can take a long time—up to 10 years. What do we know about which patients tend to have longer delays in diagnosis and care?

What some initial data supports is that diagnostic delays in at least 2 studies have been shown to be longer in White American populations. And the reasons for that are really unclear. It may be that there is a kind of a set of characteristics that people associate with HS, and it makes it makes diagnosing HS in certain populations easier than in others. But it's really kind of unclear why that is the case.

More broadly, just taking a step back, one of the things that would really improve HS diagnosis is just improved medical education. Until relatively recently, medical students were not hearing about HS in the context of medical schools. It's not something you'd see routinely in internal medicine or in residency—unless you are a dermatology resident. I think some of that is changing at some institutions. But we really need to think about introducing common dermatologic diseases to a broader group of providers so that they can at least have heard of it and understand what the very basic diagnostic criteria for a condition like HS is, and not miss a diagnosis that has irreversible ramifications for patients.

I think I'd be remiss if I didn't mention that part of what has driven diagnostic delay has not only been just a history of neglect of HS patients, more broadly, in terms of the shame and stigma that's been associated with this condition—even when patients are going into a doctor's office to get a diagnosis—but also the history of racism in medicine that has contributed to neglect of certain patient populations, in particular Black Americans, and has really hindered the ability to get patients into the office to get an accurate diagnosis in a timely fashion.