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Hidradenitis Suppurativa - Symptoms and Treatment

Hidradenitis suppurativa or HS is a skin disease that affects areas bearing apocrine sweat glands and hair follicles ; such as the underarms, groin and buttocks, and under the breasts in women. Initially, they starts as one or more red, tender, swellings in the groin or axilla. But after few days, these lesions enlarge and often open to the skin surface draining all of its yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission. The condition most commonly occurs between 20-40 years and coincides with the post-pubertal increase in androgen levels. Women are affected by hidradenitis suppurativa three times as often as men; the reason for this is unknown. Often, patients with hidradenitis suppurativa also are afflicted with acne, pilonidal cysts, and chronic scalp folliculitis; thus, giving rise to the term follicular occlusion tetrad. HS is often called an 'orphan illness', due to little research being conducted on the disease at this time. Pain is a common symptom in chronic disease. Over time, fibers of scar tissue branch out, creating restrictive, tight skin. HS sufferers may go through severe bouts of depression, avoid public and inter-personal contact, become sedentary and often overweight. Hidradenitis suppurativa tends to start after puberty, persist for years and worsen over time.

Causes of Hidradenitis Suppurativa

Common Causes of Hidradenitis Suppurativa :

  • The main cause of hidreadenitis suppurativa is enlargement in the sweat (apocrine) glands, either by perspiration or because incomplete development makes it difficult for them to drain properly. The trapped fluids are then forced into the surrounding tissue, causing inflammation and infection.
  • A genetic predisposition to hidradenitis suppurativa likely exists, with one study noting that 38% of patients had a relative with hidradenitis.
  • Obesity is not a cause Hidradenitis suppurativa but it can make it worse.
  • Hidradenitis may become worse under stress.
  • Hidradenitis Suppurativa has been seen to appear more frequently in smokers than non-smokers.
  • Apocrine sweat glands are stimulated by androgen and suppressed by oestrogen.
  • Another reason is bacterial infection.
  • Excessive sweating may also be a cause of the disease.
  • The disease generally affects multiple members of a family.

Symptoms of Hidradenitis Suppurativa

Some common Symptoms of Hidradenitis Suppurativa :

  • Depression and social isolation may also occur.
  • Scarring.
  • Pus leaking from openings in the swellings.
  • Weight loss.
  • Fever.

Treatment of Hidradenitis Suppurativa

  • Topical antibiotics (applied to the skin) are the treatment of choice. Systemic ( by mouth) antibiotics are at times necessary when the condition is flaring or when a patient has a severe case.
  • Tight-fitting clothing is to be strictly avoided.
  • Radiotherapy can also be an effective method for the treatment of Hidradenitis suppurativa .
  • Intralesional corticosteroid injections can also be used to cure the disease.
  • Warm compresses , baths may soothe the condition.
  • Usually remove the disease by surgery.
  • Contraceptive Pills and the combination of estrogens with 100 mg of cyproterone acetate have been used.
  • High-dose systemic steroids (eg, prednisolone 60 mg/d) are useful as adjuvant's to antibiotics, and they act by reducing the inflammatory process.
  • Weight loss will also help in controlling hidradenitis suppurativa.








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