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Hidradenitis suppurativa

This is a long term problem that is rather distinct.  Patients get boils over the armpits, groins, around the bottom.  All areas may be affected or one single area is affected.  The boils tend to be large, point and then burst leaving behind scars or even sinuses that discharge pus.

It can affect any sex although it is more common in patients with acne.  It is thought to be due to blockage in the openings of follicles resulting in inflammation that also involves certain special glands called “APOCRINE GLANDS”.  These glands are found in the armpits, groins and around the anal area.

Early lesions start as reddish lumps that are painful and slowly enlarge.  These may then breakdown to discharge pus.  The scars are quite massive and link to each other and are called “Bridging scars”.

Rarely patients can have a condition called FOLLICULAR occlusion TETRAD (4 conditions happening together in the same patient.)

1. Acne conglobata (severe facial acne)
2. Dissecting cellulitis of scalp (inflammation in scalp)
3. Pilonidal cysts (sinuses in buttocks)

Treatment

1. Antibiotic treatment – This may be given for many weeks.
2. Oral steroids or intralesional steroids.  
3. Sometimes in resistant cases a drug called isotretinoin can be tried  with varied success.

Additive measures that help to lessen intensity of Hidradenitis include

1. Weight reduction
2. Increased personal hygiene
3. Antibacterial soaps
4. Anti per spirants

The final method of treatment is to remove the entire area by surgical excision.  This should be done by surgeons with experience of the procedure.

  SEE ALSO SWEATING AND SKIN

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