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Hidradenitis Suppurativa

(Acne Conglobata; Acne Inversa [AI]; Apocrine Acne; Apocrinitis; Fox-Den Disease; HS; Hydradenitis Suppurativa; Pyodermia Significa Fistulans; Velpeau's Disease; Verneuil's Disease)

Pronounced: HID-ra-den-EYE-tis SUP-you-rah-TEE-vah
En Español (Spanish Version)

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Hidradenitis suppurativa (HS) is an inflammatory condition of the hair follicle. Recurrent, inflamed nodules and cysts form in the armpits and groin. These may also be found under the breasts, and around the nipples and anus.

Sweat Gland

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Causes

The hair follicle becomes blocked causing inflammation of the sweat glands. The blockage may lead to absesses, infection, or scarring.

Risk Factors

HS is more common in women than in men. Other factors that increase your chances of getting HS include:

Symptoms

Symptoms may include:

  • Burning, itching, or painful lumps in the armpits, groin, under the breasts, around the nipples, or around the anus
  • Pus leaking from openings in the lumps
  • Excessive sweating
  • Scarring

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. In most cases, the doctor will be able to make a diagnosis by looking at the nodules.

Treatment

Talk with your doctor about the best treatment plan for you. Options may include one or more of the following:

You may be able to improve the condition by taking these steps:

  • Use warm compresses to relieve discomfort and promote abscess drainage
  • Avoid shaving if skin becomes irritated
  • Wear loose-fitting, nonsynthetic clothing
  • Use antibacterial soap
  • Try to avoid heat and humidity

If you smoke, talk to your doctor about finding a program to help you quit. It is also important to maintain a healthy weight and eat a balanced diet. If you need help with losing weight, consider talking to a dietitian who can help you with meal planning.

Your doctor may prescribe one or more therapies depending on the severity of your HS.

Your doctor may recommend oral or topical antibiotics.

Corticosteroids may help improve symptoms. These can be taken by mouth, applied to the skin, or injected into the area.

Other medications called biologics, which decrease the bodies immune response, may be used in severe cases. These medications have many risks, so your doctor will carefully weigh the risks and benefits of using these.

Hormonal medications, such as oral contraceptives can used in some cases. At other times, medications called retinoids may be used.

Small lesions can be treated in the doctor's office. The sores may be cut open and allowed to drain. If your condition is severe, then a wide area may need to be removed. In these cases, a skin graft may be needed.

Other procedure options include:

  • Laser surgery—uses lasers to remove lesions
  • Cryosurgery—uses cold to freeze lesions

Prevention

To help reduce your chances of getting HS, take the following steps:

RESOURCES:

American Academy of Dermatology

http://www.aad.org

Hidradenitis Suppurativa Foundation

http://www.hs-foundation.org

CANADIAN RESOURCES:

Canadian Dermatology Association

http://www.dermatology.ca

References:

Fardet L, Dupuy A, Kerob D, et al. Infliximab for severe hidradenitis suppurativa: transient clinical efficacy in seven consecutive patients. J Am Acad Dermatol. 2007;56:624-628.

Hydradenitis supparativa. British Association of Dermatologists website. Available at: http://www.bad.org.uk/site/825/Default.aspx. Updated May 2011. Accessed June 4, 2013.

Hydradenitis supparativa. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 26, 2013. Accessed June 4, 2013.

Hydradenitis supparativa. National Organization of Rare Diseases website. Available at: http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/358/viewFullReport. Updated September 14, 2012. Accessed June 4, 2013.

Lam J, Krakowski AC, Friedlander SF. Hidradenitis suppurativa (acne inversa): management of a recalcitrant disease. Pediatr Dermatol. 2007;24(5):465-473.

Shah N. Hidradenitis suppurativa: a treatment challenge. Am Fam Physician. 2005;72(8):1547-1552.

Last reviewed June 2013 by Ross Zeltser, MD; Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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