Neuropathic Pain Management Using Novel Biologics in Moderate-to-Severe Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is an extremely painful skin condition with both nociceptive and neuropathic components. Biologics may offer superior neuropathic pain relief and impede worsening of this disease compared to other treatments. Of the three currently FDA-approved biologics (adalimumab, bimekizumab, and secukinumab), bimekizumab shows the largest absolute reduction in skin pain and the earliest onset of pain improvement. This review explores the pathophysiology and causes of neuropathic pain development in HS, highlights current FDA-approved and emerging biologics for its management, and raises awareness of neuropathic pain in HS. Clinical trial data assessing pain are unstandardized, and further elucidation of pain outcomes using standardized assessments of neuropathic pain is crucial for determining whether biologics targeting mediators that drive neuropathic pain development are effective in treating this aspect of HS.