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Diseases and Conditions
Hidradenitis suppurativaFrom MayoClinic.com
Special to CNN.com
Hidradenitis suppurativa is a chronic skin inflammation marked by the presence of blackheads and one or more red, tender bumps (lesions). The lesions often enlarge, break open and drain pus. Scarring may result after several occurrences.
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. But early diagnosis and treatment can help manage the symptoms and prevent new lesions from developing.
Signs and symptoms
Hidradenitis suppurativa commonly occurs around hair follicles where many oil and sweat glands are found, such as the armpits, groin and anal area. It may also occur in areas where skin rubs together, such as the inner thighs, under the breasts or between the buttocks. Hidradenitis suppurativa can affect a single area or multiple areas of the body.
Signs and symptoms of hidradenitis suppurativa include:
For some people, the disease progressively worsens and affects multiple areas of their body. Other people experience only mild symptoms. Excess weight, stress, hormonal changes, heat or excessive perspiration can worsen symptoms.
Hidradenitis suppurativa develops when the oil glands and hair follicle openings become blocked. When oils and other skin products become trapped, they push into surrounding tissue. Bacteria can then trigger infection and inflammation. It's not known why this occurs, but a number of factors — including hormones, genetics, cigarette smoking and excess weight — may all play a role.
Sometimes hidradenitis suppurativa occurs with other diseases, such as Crohn's disease, herpes simplex or Grave's disease.
When to seek medical advice
Mild cases of hidradenitis suppurativa may be treated with self-care measures. But if the condition doesn't improve in one to two weeks, appears in several locations, recurs often or is painful, consult your doctor or a dermatologist. Most often, medical treatment — such as prescription medications or surgery — is necessary to manage the problem.
Screening and diagnosis
To make a diagnosis, your doctor may ask about your symptoms and medical history, examine your skin, and order blood tests. If pus or drainage is present, your doctor may send a sample of the fluid to a laboratory for testing. This test is known as a culture. Such tests may be necessary to rule out other skin conditions, such as tuberculosis of the skin, a carbuncle or a pilonidal cyst.
Hidradenitis suppurativa often causes complications when the disease is persistent and severe. These complications include:
There is no cure for hidradenitis suppurativa. But early treatment can help manage the symptoms and prevent new lesions from developing.
Treatments depend on the extent of the affected areas and whether the sores are painful or infected. Mild cases can be treated with self-care measures, including warm compresses and regular washings with antibacterial soap. Moderate cases may require medications, such as those you rub on the affected areas (topical medications) or those you take by mouth (oral medications). Possible medications include:
For severe or persistent cases or for deep lesions, surgery may be necessary.
Obesity, incomplete removal and ongoing skin infections can increase the chances that hidradenitis suppurativa returns, even after surgical treatment.
The following suggestions may help relieve discomfort, speed healing and prevent the infection from spreading:
Excess weight increases the number of areas where skin rubs together — for example, between skin folds — causing friction, increased perspiration and bacterial growth. Though weight loss won't cure the disease, it may improve symptoms.
September 22, 2006