Hidradenitis suppurativa (HS) is a clinically heterogeneous disease with few effective treatments.1 While clinical examination forms the basis for HS diagnosis and evaluation, HS clinical heterogeneity poses substantial challenges for assessing disease severity, activity, and treatment response.2 Efforts to accurately quantify HS severity and treatment response have resulted in the development of more than 30 investigator- and patient-reported outcome measures, several of which are unvalidated and some of which are unresponsive to changes in disease, that have been used in more than 12 randomized clinical trials, thus limiting comparisons of evidence across trials.3