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IL-17 has been shown to play a key role in the pathogenesis of HS and evidence highlights the potential of IL-17-targeted therapies. The fully human IgG\/\u03ba monoclonal antibody secukinumab, which specifically targets IL-17A and inhibits interaction with its receptor, has recently been approved for the treatment of moderate-to-severe HS. Secukinumab offers patients an efficacious and well-tolerated treatment option in terms of sustained response by rapidly improving signs and symptoms, and preventing disease progression in the absence of loss of response. Being a challenging disease, HS is associated with a delay to diagnosis of 3\u201310\u00a0years and, consequently, late implementation of appropriate treatment, leading to disease progression. Misdiagnosis due to flawed understanding and lack of awareness among medical providers and patients is considered an important factor contributing to the delayed diagnosis. Thus, serious efforts must be made on a large scale to urgently reduce the delay in HS diagnosis and reduce the disease burden in patients, including raising awareness, implementation of education programmes at medical and specialisation schools, as well as continuous education of healthcare providers at different levels for the early detection of HS and initiation of appropriate treatment. Here, we present the main critical unmet needs in the diagnosis and treatment of patients affected by HS, address how disease awareness and comprehensive multidisciplinary management (offering both medical and surgical care) can benefit patients, and suggest therapeutic options, based on clinical characterisation and early identification and intervention (window of opportunity), to be adopted for a timely and better management of disease progression and to fill current gaps.<\/jats:p>","DOI":"10.1007\/s00403-025-04016-1","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T18:31:12Z","timestamp":1740767472000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hidradenitis suppurativa, from basic science to surgery and a new era of tailored targeted therapy: An expert opinion paper"],"prefix":"10.1007","volume":"317","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-4169","authenticated-orcid":false,"given":"Angelo Valerio","family":"Marzano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1099-3283","authenticated-orcid":false,"given":"Michele","family":"Bartoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2760-4600","authenticated-orcid":false,"given":"Vincenzo","family":"Bettoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-0387","authenticated-orcid":false,"given":"Andrea","family":"Chiricozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5920-6191","authenticated-orcid":false,"given":"Mario","family":"Clerici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Dapavo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8537-1999","authenticated-orcid":false,"given":"Valentina","family":"Dini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-9788","authenticated-orcid":false,"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-4925","authenticated-orcid":false,"given":"Cristina","family":"Magnoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1803-2046","authenticated-orcid":false,"given":"Matteo","family":"Megna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5157-3939","authenticated-orcid":false,"given":"Giuseppe","family":"Micali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7939-0026","authenticated-orcid":false,"given":"Elisa","family":"Molinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5997-2045","authenticated-orcid":false,"given":"Francesca","family":"Prignano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"4016_CR1","doi-asserted-by":"publisher","first-page":"2094","DOI":"10.3390\/cells10082094","volume":"10","author":"E Scala","year":"2021","unstructured":"Scala E, Cacciapuoti S, Garzorz-Stark N, Megna M, Marasca C, Seiringer P, Volz T, Eyerich K, Fabbrocini G (2021) Hidradenitis suppurativa: where we are and where we are going. 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FP served as advisory board member and consultant and has received fees and speaker's honoraria or has participated in clinical trials for AbbVie, Almirall, Leo Pharma, Eli Lilly, Janssen, Novartis, Biogen, Sanofi Genzyme, UCB, Boehringer Ingelheim, Pfizer and Bristol Meyers Squibb. VB served as a board member, speaker or investigator for AbbVie, Cantabria, Galderma, General Topics, LaRoche Posay, Ganassini, L\u2019Oreal, Novartis, Sanofi and UCB, and received grant for their institution from AbbVie. EM served as advisory board member and consultant and has received fees and speaker's honoraria or has participated in clinical trials for AbbVie, Janssen, Novartis, UCB and Boehringer Ingelheim. CF served as an investigator and or\/speaker for AbbVie, Amgen, Boehringer Ingelheim, Incyte, LEO Pharma, Ely Lilly, Pfizer, Novartis, Pfizer and Sanofi. CM served as a member of advisory boards, as a consultant and has participated in sponsored clinical trials for AbbVie, Almirall, Integra LifeSciences, MedSkin Solutions, Novartis, Sanofi, Fidia Farmaceutici S.p.A, GSK and Holostem Srl. VD served as an advisory board member, or consultant and has received fees and speaker's honoraria or has participated in sponsored clinical trials for AbbVie, Almirall, Convatec, Eli Lilly, Leopharma, Johnson & Johnson, Novartis, UCB and Boehringer Ingelheim. LB served as member of advisory boards, consultant and received fees and speaker's honoraria or PI in clinical trials for AbbVie, Janssen, Novartis, UCB, Boehringer Ingelheim. Novartis, Sanofi, Biogen, Pfizer, La Roche Posay and Cantabria. GM has received consultancy\/advisory boards disease-relevant honoraria from Boehringer Ingelheim, Bristol Myers Squibb, Incyte, LEO Pharma, Novartis, Pfizer, Sanofi and UCB. MM acted as a speaker or consultant for AbbVie, Amgen, Almirall, Janssen, Eli Lilly, Leo Pharma, Novartis and UCB. MB received advisory board disease-relevant honoraria from Novartis. MC and AC declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"511"}}