Hidradenitis suppurativa (HS) is a chronic skin disease with limited effective treatments, and the identification of novel therapeutic drugs are essential for disease management. Oral roflumilast is a selective phosphodiesterase-4 (PDE4) inhibitor indicated to manage chronic obstructive pulmonary disease,1 that has proven efficacious in off-label treatment of patients with moderate to severe psoriasis.2 In HS, oral roflumilast has demonstrated effectiveness in a single case study,3 whereas studies on other PDE4-inihibitors such as apremilast4 and orismilast5 have shown varying results. We examined the effectiveness, safety and drug survival of oral roflumilast in adult outpatients with HS.