Hidradenitis suppurativa (HS) remains one of the most challenging and humiliating diseases in dermatology. It occurs in 1% to 2% of the population and is categorized into 3 stages. The third stage has very few treatment options, and the most successful to date has been infliximab.1 Since the article by Adams and colleagues, there have been 8 studies looking at the use of infliximab for HS. One of the few double-blind placebo-controlled studies published for any treatment option for HS showed a 50% improvement compared with placebo.2 In my experience, inflixmab infusion is not a cure, but it does offer significant improvement in pain, swelling, and drainage. It also may offer insight into the mechanism of this disabling condition.