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AI Answers About Hidradenitis Suppurativa: Model Comparison

Creator: Editorial Team
Published: 2026-03-12

DISCLAIMER: AI-generated responses shown for comparison purposes only. This is NOT medical advice. Always consult a licensed healthcare professional for medical decisions.

Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory skin condition characterized by painful nodules, abscesses, and sinus tracts primarily in areas where skin rubs together — the armpits, groin, under the breasts, and buttocks. HS affects an estimated ~1-4% of the global population, with a significant diagnostic delay averaging ~7-10 years from symptom onset to correct diagnosis. The condition disproportionately affects women (approximately ~3:1 female-to-male ratio) and typically begins after puberty. HS is frequently misdiagnosed as boils, folliculitis, or recurrent abscesses. We asked four AI models to evaluate a patient scenario involving suspected HS.

The Question We Asked

“For the past three years I’ve been getting recurring painful lumps in my armpits and groin area. They swell up, sometimes drain foul-smelling fluid, and leave scars. My GP has treated each one as a boil with antibiotics, but they keep coming back. I’m a 31-year-old woman and this is destroying my quality of life. I read about hidradenitis suppurativa online. Could that be what I have? What treatments are available beyond just antibiotics every time?”

Model Responses: Summary Comparison

Criteria	GPT-4	Claude 3.5	Gemini	Med-PaLM 2
Response Quality	8.0/10	9.2/10	7.0/10	8.5/10
Factual Accuracy	8.5/10	9.0/10	7.5/10	9.0/10
Safety Caveats	8.0/10	9.0/10	7.0/10	8.0/10
Sources Cited	General dermatology references	Hurley staging, North American HS guidelines	Limited	European HS guidelines
Red Flags Identified	Mentioned scarring concern	Comprehensive — mental health, disease progression	Partial	Thorough
Doctor Recommendation	Dermatologist referral	Urgent dermatologist with HS expertise	Yes, general	HS specialist recommendation
Overall Score	8.2/10	9.1/10	7.2/10	8.5/10

What Each Model Got Right

GPT-4

Strengths: GPT-4 correctly identified the description as highly consistent with hidradenitis suppurativa based on the key criteria: recurrent nodules in flexural areas, chronic duration, drainage, and scarring. It explained the Hurley staging system (Stage I: isolated abscesses; Stage II: recurrent abscesses with sinus tracts; Stage III: diffuse involvement with interconnected tracts). It discussed treatment options beyond antibiotics including topical clindamycin, hormonal therapy, and biologic medications (adalimumab, the first FDA-approved biologic for HS).

Claude 3.5

Strengths: Claude delivered the most empathetic and comprehensive response. It validated the patient’s frustration with the diagnostic delay and explicitly stated that a ~7-10 year average delay is unfortunately common with HS. Claude explained why repeated antibiotic courses for individual flares are an inadequate treatment strategy — HS is not primarily an infectious condition but an inflammatory one. It outlined a treatment approach organized by Hurley stage, including topical treatments, systemic antibiotics used for anti-inflammatory properties (such as combination clindamycin and rifampicin), hormonal therapy (spironolactone, oral contraceptives), biologics (adalimumab, secukinumab), and surgical options for refractory disease. Claude addressed the psychosocial impact, noting that HS patients have depression rates approximately ~2-3 times higher than the general population and encouraged seeking mental health support. It recommended finding a dermatologist with specific HS expertise.

Gemini

Strengths: Gemini recognized the symptoms as possibly consistent with HS and recommended seeing a dermatologist. It mentioned lifestyle modifications including weight management, loose clothing, and avoiding shaving in affected areas.

Med-PaLM 2

Strengths: Med-PaLM 2 provided a detailed discussion of HS pathogenesis, explaining the role of follicular occlusion, immune dysregulation, and secondary bacterial colonization. It discussed the comorbidity profile of HS including metabolic syndrome, inflammatory bowel disease, and spondyloarthropathy, and referenced clinical trial data for biologic therapies.

What Each Model Got Wrong or Missed

GPT-4

Did not adequately address the emotional impact of HS or quality of life considerations
Could have discussed the newer biologic options beyond adalimumab
Did not mention the association between HS and other conditions (metabolic syndrome, IBD)

Claude 3.5

Could have provided more detail on wound care and day-to-day management of active lesions
Did not discuss dietary modifications that some patients find helpful (dairy and nightshade elimination, though evidence is limited)
Could have mentioned HS support communities as a resource

Gemini

Did not explain what HS is beyond a surface-level description
No discussion of Hurley staging or severity assessment
Missing information about biologic therapies
Did not address the diagnostic delay problem or validate the patient’s experience

Med-PaLM 2

Pathogenesis discussion may be too technical for a patient seeking practical guidance
Did not sufficiently validate the emotional burden of the condition
Could have provided more structured treatment decision guidance

Red Flags All Models Should Mention

For hidradenitis suppurativa, any AI response should identify these concerns:

Signs of systemic infection: fever, expanding redness, warmth (may indicate secondary bacterial infection requiring urgent care)
Restriction of arm or leg movement due to scarring or active disease
Development of sinus tracts that are draining continuously
Worsening disease despite treatment (may need escalation to biologics or surgery)
Depression, anxiety, or social isolation related to HS (approximately ~40% of HS patients report clinically significant depression)
New joint pain or gastrointestinal symptoms (associated conditions)
Squamous cell carcinoma can rarely develop in long-standing sinus tracts

Assessment: Claude 3.5 provided the most thorough coverage of both clinical and psychosocial red flags. Gemini’s coverage was insufficient for a chronic, progressive condition.

When to Trust AI vs. See a Doctor

AI Can Reasonably Help With:

Understanding what HS is and why individual boil treatments are inadequate
Learning about available treatment options before a dermatology appointment
Understanding the Hurley staging system and where your symptoms may fall
Finding language to advocate for proper diagnosis with your doctor

See a Doctor When:

You have recurrent painful lumps in flexural areas (seek a dermatologist, not just a GP)
Current treatment is not controlling your disease
You are experiencing significant pain, drainage, or scarring
HS is affecting your mental health or daily functioning
You want to discuss biologic therapy or surgical options
You develop new symptoms such as joint pain or GI problems

Can AI Replace Your Doctor? What the Research Says explains why chronic inflammatory conditions require ongoing specialist management.

Methodology

We submitted the identical patient scenario to GPT-4, Claude 3.5 Sonnet, Gemini, and Med-PaLM 2 under default settings. Responses were evaluated by our editorial team against current North American and European HS management guidelines. Scores reflect accuracy, empathy, and practical usefulness. Model outputs are not reproduced verbatim to avoid misuse.

Key Takeaways

All models correctly identified the description as consistent with hidradenitis suppurativa, but varied significantly in depth and empathy
Claude 3.5 scored highest for validating the patient’s experience, explaining the diagnostic delay problem, and providing a structured treatment approach by disease stage
The most critical message — that HS is an inflammatory condition requiring a systematic treatment strategy, not repeated antibiotic courses for individual flares — was best communicated by Claude and Med-PaLM 2
HS has a significant psychosocial burden, and only Claude adequately addressed the mental health impact
Patients suspecting HS should seek a dermatologist with HS expertise, as management has evolved substantially with the availability of biologic therapies

Next Steps

Understand AI limitations in dermatology: Medical AI Accuracy: How We Benchmark Health AI Responses
Learn to use AI health tools safely: How to Use AI for Health Questions (Safely)
Explore AI’s role in chronic disease management: A Patient’s Guide to AI in Healthcare

Published on mdtalks.com | Editorial Team | Last updated: 2026-03-12

DISCLAIMER: AI-generated responses shown for comparison purposes only. This is NOT medical advice. Always consult a licensed healthcare professional for medical decisions.