Aims: There is currently no evidence-based guideline to show how to manageimmunosuppressive treatment in patients with hidradenitis suppurativa (HS) during theCoronavirus disease-2019 (COVID-19) pandemic. Therefore, we updated our routine clinicalprotocol to 1) inform patients with ongoing treatment about the potential risks of theirmedications in the case of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)infection, 2) discuss opt out of treatment temporarily, and 3) perform a closer follow-up ona monthly basis. The aim of this study was to evaluate the clinical outcomes in patients withHS, who suspended and continued immunosuppressive therapy following COVID-19 outbreak. Methods: This retrospective study included patients with HS, who had been receiving biologic/ immunosuppressive treatment when the COVID-19 pandemic was announced. Those whowithdrew treatment for any reason or continued were analyzed. The primary endpoint wasphysician-diagnosed disease exacerbation. The secondary outcomes were changes in visualanalogue scale (VAS) and COVID-19 diagnosis. Results: A total of 37 patients were included in the analysis. The majority of the patients were onadalimumab treatment (n=33). Fifteen (40.5%) patients withdrew the treatment for COVID-19related concerns. During 83.2±0.6 days of follow-up following the withdrawal, all patients inthis group had at least one exacerbation. Also, the mean VAS score increased from 5.7±0.56 to8.6±0.57 (p=0.001). On the other hand, three patients (13.6%) who continued the treatmentreported worsening in disease course, 12 patients (54.5%) remained stable and seven of them(31.9%) had clinical relief. We did not observe any confirmed SARS-CoV-2 infection in any of our37 HS patients. Conclusions: The present study suggests that even a temporary withdrawal of biologic/ immunosuppressive treatments may have significant adverse consequences on disease courseand quality of life in patients with HS. These individuals may safely continue the treatmentprovided that maximum measures are taken to avoid COVID-19 infection.