Does severe genital hidradenitis suppurativa warrant screening for Crohn’s disease, and what diagnostic evaluation do you perform?

I think that the possibility of Crohn's disease should be considered in a person with anogenital HS when responsive to treatment is not what is expected or the presentation has certain manifestations, e.g., knifelike ulcers or areas directly adjacent to the anus. Of course, a full history and ROS, and then strongly consider a biopsy to evaluate for cutaneous Crohn's disease and referral to a gastroenterologist with an interest in inflammatory bowel disease.