Non-Occupational Dermatological Diseases with Significant Professional Impact: Severe Hidradenitis Suppurativa as a Case-Based Illustration

Abstract Dermatological diseases should not be omitted as cause of functional impairment or reduced work capacity, even when they are not formally classified as occupational. Chronic inflammatory dermatoses may interfere substantially with professional activity through pain, mobility limitation, recurrent exacerbations, and psychosocial burden. Hidradenitis suppurativa (HS) is a paradigmatic example of a non-occupational skin disease with major implications for work ability and employment stability. This article aims to highlight the occupational impact of severe HS through a detailed clinical case and to discuss workplace-related aggravating factors and management strategies relevant to occupational medicine. We present the case of a 46-year-old male with severe HS (Hurley stage III), integrating clinical, laboratory, histopathological, and occupational health assessments. Disease severity and burden were evaluated using the International Hidradenitis Suppurativa Severity Score System (IHS4) and the Dermatology Life Quality Index (DLQI). Despite multiple systemic treatments, disease control remained incomplete, with recurrent inflammatory flares requiring hospitalization. Several occupational factors, including mechanical friction, heat, sweating, chemical exposure, and tobacco smoke, were identified as contributors to disease exacerbation. The condition resulted in marked work disability, characterized by reduced work ability, absenteeism, presenteeism, and fear of job loss. This case underscores the importance of recognizing the professional impact of non-occupational dermatological diseases and supports the integration of occupational health strategies into the multidisciplinary management of hidradenitis suppurativa.