Skin conditions can't affect pregnancy outcomes, right? After all, the skin is just the skin. WRONG! As a chronic inflammatory disease, hidradenitis suppurativa (HS) exemplifies the link between integumentary and comorbid systemic disease through shared inflammatory pathways. Patients have double the comorbidity burden compared with the general population, and hidradenitis suppurativa has independent associations with several individual comorbid diseases. During pregnancy, HS also is associated with some specific pregnancy related morbidities. Successful management of hidradenitis suppurativa is challenging and at times requires comprehensive care from a coordinated team of health care professionals, including dermatologists, general or plastic surgeons, experts in pain management and wound care. In this episode, we ill summarize the pathogenesis of HS, its treatment, and its affect on pregnancy and vice-versa.