Hidradenitis suppurativa

Hidradenitis suppurativa
Hidradenitis suppurativa (Hurley's staging II) in the left armpit
Classification and external resources
Specialty	Dermatology
ICD-10	L73.2
ICD-9-CM	705.83
DiseasesDB	5892
eMedicine	emerg/259 med/2717 derm/892
Patient UK	Hidradenitis suppurativa
MeSH	D017497
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Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic skin disease characterized by clusters of abscesses or subcutaneous boil-like "infections" (often free of actual bacteria) that most commonly affects the underarms, under the breasts, inner thighs, groin, and buttocks. Outbreaks are painful and may persist for years with interspersed periods of inflammation, often culminating in sudden drainage of pus. This process often forms open wounds that do not heal and frequently leads to significant scarring.

Persistent lesions may lead to the formation of sinus tracts, or tunnels connecting the abscesses or infections under the skin. At this stage, complete healing is usually not possible, and progression is variable, with some experiencing remission for months to years at a time, while others may worsen and require multiple surgeries. Bacterial infections and cellulitis (deep-tissue inflammation) are other common complications of HS. Depression and pain are often seen with HS and can be difficult to manage. HS often goes undiagnosed for years due to embarrassment causing delay in seeking treatment.

HS flares may be triggered by emotional/erotic stress, sweating, hormonal changes, heat, and humidity, and the condition is exacerbated by friction from clothing. The disease is not contagious. Heredity is indicated among certain ethnic groups and is autoimmune in nature. Onset is most common in the late teens and early 20s. For unknown reasons, people with HS develop plugging of their apocrine glands.

Currently no cure nor any consistently effective treatment is known. Incision and drainage procedures may provide symptomatic relief. Carbon dioxide laser surgery may be an effective treatment with a low chance of recurrence. Lukewarm sitz baths can provide relief; gentle antiseptic skin cleansers and hydrogen peroxide assist in keeping affected areas free of bacteria. The number of people affected is not well established, but has been estimated as being between 1:24 (4.1%) and 1:600 (0.2%).

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