Section Summary

  • A single physical examination may substantially underestimate fluctuating HS.
  • A concise longitudinal history should cover recurrence, locations, drainage, pain, function, and prior treatment response.
  • Patient-reported burden can change the interpretation of an apparently limited examination.
  • Sensitive, nonjudgmental language improves disclosure and helps repair mistrust created by prior dismissive care.
  • Validated patient-reported measures can support consistent follow-up but do not replace a focused conversation.
Key Takeaway: The examination shows what HS looks like today. The patient’s history shows what HS is doing over time and what it is doing to the patient.