Hidradenitis Suppurativa – Causes, Symptoms & Treatment

March 25 01:20 2019 Print This Article

Hidradenitis is a chronic and often disabling disease of the apocrine glands, which is characterized by intermittent periods of inflammation. It typically manifests itself as a progression from single boil-like, pus-filled abscesses, or hard sebaceous lumps, to painful, deep-seated clusters of lesions with chronic seepage involving significant scarring. It generally effects inverse areas of the body, top of inner thighs, bottom, genitals, armpits and less commonly the stomach, hair line and behind the ears. In women it can also occur under the breasts. It is similar to acne, which is also a disease of the sebaceous glands. Hidradenitis is more common in people who have had acne. This condition is slightly more common in African-Americans and women. Hidradenitis usually starts as one or more red, tender, swellings in the groin or axilla.

Over a period of hours to days the lesions enlarge and often open to the skin surface draining clear to yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission.- Treatment of acute cases consists of high-dose oral tetracycline (500 mg po bid) or erythromycin (250 to 500 mg po qid) until the lesions resolve. Topical clindamycin applied bid may be equally effective. Incision and drainage are necessary for an abscess or fluctuance of the affected area but alone will not resolve the problem (unlike in cutaneous abscesses). Isotretinoin 1 mg/kg po bid has also been effective in some patients, but recurrences are common. Surgical excision and repair or grafting of the affected areas are often necessary if the disease persists.

Hidradenitis is inflammation of the apocrine sweat glands located under the armpits, around or close to the anus, in genital area and under the breasts. The cause of hidradenitis suppurativa isn’t known. But it’s considered a severe form of acne (acne inversa) because it occurs deep in the skin around oil (sebaceous) glands and hair follicles. The parts of the body affected the groin and armpits, for example are also the main locations of apocrine sweat glands. Hidradenitis suppurativa tends to start after puberty, persist for years and worsen over time. There is no cure for hidradenitis suppurativa.

Hidradenitis suppurativa is a chronic, scarring inflammation of apocrine glands of the axillae, groin, and around the nipples and anus. Blockage of apocrine ducts has been suggested as the cause, leading to subsequent inflammation, bacterial overgrowth, and scarring. Staphylococcus aureus is almost always implicated in acute cases, but gram-negative organisms such as Proteus may predominate in chronic cases. Swollen, tender masses resembling cutaneous abscesses develop. Pain, fluctuance, discharge, and sinus tract formation are characteristic in chronic cases. In chronic axillary cases, coalescence of inflamed nodules causes palpable cordlike fibrotic bands. The condition may become disabling because of pain and foul odor.

Causes of Hidradenitis Suppurativa

The exact cause of hidradenitis suppurativa remains unclear. Because it looks similar to acne, some investigators believe that it is caused by the formation of keratin plugs in the follicles. Because hidradenitis suppurativa occurs in areas that contain apocrine, or sweat, glands, other investigators believe that it is caused by a blockage of the apocrine gland. In either case, the plugged gland or follicle becomes larger, ruptures, and becomes infected. Obesity and cigarette smoking may be triggering factors.

Find common causes and risk factors of Hidradenitis Suppurativa:

  • Hidradenitis Suppurativa has been seen to appear more frequently in smokers than non-smokers.
  • Obesity, hirsutism and acne are common findings among women with hidradenitis suppurativa.
  • People who have acne, also genetically predisposed, are more likely to develop Hidradenitis Suppurativa.

Signs and Symptoms of Hidradenitis Suppurativa

Sign and symptoms may include the following:

  • Scarring.
  • Fever.
  • Weight loss.
  • Boils just under the skin.
  • Discharge of pus through specially formed tracts (suppuration).
  • Tunnels that form under the skin between abscesses.

Treatment for Hidradenitis Suppurativa

Treatment may include:

  • Topical Antibiotics are one of the best treatment option for curing hidradenitis suppurativa fast. It is applied over the affected skin.
  • Contraceptive Pills and the combination of estrogens with 100 mg of cyproterone acetate have been used.
  • Weight loss will also help in controlling hidradenitis suppurativa.
  • Tight-fitting clothing is to be strictly avoided.
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