Hidradenitis suppurativa remains one of the most misdiagnosed conditions in dermatology, and Luis Garza, M.D., Ph.D., has taken a direct approach to fixing that: in a new interview with Managed Healthcare Executive, he explains the disease by defining what it is not.

Garza, a dermatologist and researcher known for his work on skin regeneration and inflammatory disease, used the conversation to strip away the assumptions that delay HS diagnoses and burden patients. The interview format is deliberately corrective. Rather than opening with disease mechanisms, Garza works through the misconceptions first — the framing that has made HS a condition patients often live with for years before receiving accurate care.

Hidradenitis suppurativa is a chronic inflammatory skin disease. It typically presents with painful nodules, abscesses and scarring in intertriginous areas — the armpits, groin and under the breasts. Because those lesions are frequently mistaken for isolated boils, ingrown hairs or poor hygiene, patients are often misdiagnosed, and the average diagnostic delay for HS stretches across years in most published cohort studies. Garza's "what it is not" framing targets exactly that gap.

What does this change for patients and payers?

For a managed-care audience, the distinction matters in practical terms. When HS is not recognized as what it is — a systemic inflammatory condition rather than a series of recurrent infections — treatment pathways stall. Patients cycle through incision and drainage, repeated antibiotic courses and emergency visits instead of reaching appropriate dermatologic management.

Garza's interview lands at a moment when payer attention to HS is rising. Biologic therapy for the condition has expanded treatment options, and accurate diagnosis is the gatekeeper to them. A physician of Garza's profile correcting the record publicly gives primary care teams and utilization reviewers a cleaner mental model: recurrent abscesses in flexural areas are not a hygiene problem, not random bad luck, and not something to treat episodically forever.

Why the messenger matters

Garza brings both clinical and scientific credentials to the conversation — an M.D. and a Ph.D., and a research career that includes wound healing and skin regeneration. When he says the field needs to unlearn its assumptions about HS, he is speaking with the standing of someone who studies inflammatory skin disease at the mechanism level.

The interview is short, but its logic is durable. Define the disease by its look-alikes, and you sharpen the referral trigger. Sharpen the referral trigger, and the diagnostic delay shortens.

Whether that message reaches the primary care offices where most HS patients first present — and shortens the years many wait for a correct diagnosis — will be the measure of interviews like this one.