What is hidradenitis suppurativa?
Hidradenitis is a skin condition that is characterized by multiple, recurrent abscesses, boils or nodules. These skin lesions can be small or large, usually tender and red, and can cause scar tissue. The areas most often affected are the underarm, groin, and area around the recturm, although many other regions may also be affected. The drainage is often involves pus (to "suppurate" means to create pus, giving the name of the condition). One characteristic hallmark of the condition is that pressure on one nodular area may produce drainage from a different site. Hidradenitis Suppurativa can frequently leads to scarring in the affected areas.
Does HS run in the family?
One third of patients with HS have a family member who also have HS.
What is the cause of hidradenitis?
At times, bacteria can cause HS to flare up. Other times, flares start for no reason. Current data suggests that this condition starts with inflammation within the pore. The pore ruptures, leading to the development of tunnels and pockets of purulent drainage beneath the skin. Healing from these lesions may form cords or bands of scarring as the body tries to build a "wall" around the regions of inflammation.
What are other features of hidradenitis?
Frequently hidradenitis may be seen in an individual that has also experienced significant acne. Less commonly, there may be boils present within the scalp, or a boil-like lesion present at the base of the spine referred to as a pilonidal cyst.
In some patients, worsening with hormonal cycling has occurred. However hormone levels are generally normal. Patients who are overweight or of African American heritage may be more severely affected. Cancerous change within the skin lesions has been reported but is quite rare. It is not associated with internal cancers.
How is hidradenitis treated?
Hidradenitis may be divided into early and late stages. In the early phase of hidradenitis, patients may experience individual tender nodules, usually without communication with other pores. With time, many persons will experience tunneling with multiple tender, red nodules connecting below the skin surface. The drainage of pus from either solitary or multiple lesions is characteristic. Tenderness and a foul odor are very common.
Topical antibiotics to prevent flares
Humira or "Biologic" therapy, is the only FDA approved therapy currently available in the United States for HS
Surgery usually worsens scarring and worsens HS.