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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Hidradenitis suppurativa

*


* Not a rare disease
Other Names for this Disease
  • Acne inversa
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My friend has hidradenitis suppurativa. Can you please help me find more information?

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What is hidradenitis suppurativa (HS)?

Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent, painful, boil-like lumps (nodules) under the skin. HS affects the areas around skin folds (e.g., armpits, groin, and breasts) and where apocrine glands (a form of sweat gland) and hair follicles are found. It is not contagious, but it is recurrent. It typically manifests as a single boil-like, pus-filled abscess or hard sebaceous lumps (lumps composed of sebum, or oil, which is excreted by the sebacous glands associated with hair follicles) and may progress to painful, deep-seated, inflamed clusters of lesions with chronic seepage involving significant scarring.[1][2] The specific cause of HS is unknown, although it probably results from a combination of genetic and environmental factors.[3] 
Last updated: 6/7/2011

Who is most likely to be affected by hidradenitis suppurativa?

HS occurs more commonly in women and usually occurs in the third decade of life. [4]
Last updated: 7/2/2013

What are the signs and symptoms of hidradenitis suppurativa?

Hidradenitis is the medical term for inflammation of hair follicles, oil (sebaceous) ducts, and sweat glands in the skin. The term suppurativa means that the infection causes pus to form. Those with HS develop hidradenitis due to obstruction of hair follicles, which causes secondary infection and inflammation of the apocrine glands. The lesions most commonly develop in the groin and axillae (under arms). The typical lesion is a painful inflammatory papule (small, solid, raised skin lesion), nodule, or abscess (pus-filled inflamed tissue). Affected individuals may experience pain, scarring, recurrent discharge, and smell from the lesions. It is thought that hidradenitis can be aggravated by stress, heat, sweating, or friction. Persistent lesions may lead to the formation of sinus tracts, or tunnels connecting the abscesses under the skin. At this stage, progression of the disease, bacterial infection, and cellulites (deep tissue inflammation) in the area are also likely.[4]
Last updated: 6/7/2011

What causes hidradenitis suppurativa?

The cause of HS remains unknown. While there is some controversy, HS is thought to be related to other follicular diseases, such as acne or pilonidal sinus tracts. A familial form of HS may exist.[4]
Last updated: 6/7/2011

How might hidradenitis suppurativa be treated?

There is no known cure or a consistently effective treatment. Initial treatments may involve conservative measures such as warm baths, hydrotherapy, and topical cleansing agents to reduce bacterial loads. Acute painful skin lesions may be treated with corticosteroids (e.g., prednisone) or anti-inflammatory pills (e.g., Celebrex, Advil, Naproxen, and others). Although not proven to be effective, antibiotics are often the mainstay of medical treatment, especially for lesions suspected of being super infected. Affected individuals may also be treated with oral contraceptives or other medications that address a possible hormonal cause. Oral retinoids such as isotretinoin have also been used. Other treatments that have been used with limited success include cisplatin, methotrexate, 5-alpha reductase inhibitors, and TNF-alpha inhibitors.[4][5]

In advanced cases, affected individuals may undergo surgery (e.g., laser therapy or photodynamic therapy), but recurrences of HS are not uncommon. Systemic therapies are still being researched. The goals of these therapies are to heal existing lesions and prevent the development of new lesions in the areas potentially affected by the disease.[4] [5]
Last updated: 6/7/2011

References