Hidradenitis suppurativa (HS) is a chronic debilitating skin disease producing inflamed nodules in apocrine gland–bearing skin. Treatment is often inadequate, and pain and suppuration lead to inactivity, depression, and impaired quality of life. The pandemic cluster of cardiovascular risk factors called the metabolic syndrome (MetS) occurs more commonly with chronic inflammatory diseases. In this cross-sectional study, Miller et al demonstrate that HS appears to be associated with MetS, indicating substantial comorbidities. These data suggest that patients with HS require general medical attention beyond the skin.