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Definition

Hidradenitis Suppurativa is inflammation of the apocrine sweat glands located under the armpits, around or close to the anus, in genital area and under the breasts. The disease is characterized by the development of recurrent, boil-like nodular lesions and deep pus-containing pockets of infection (abscesses) that may eventually rupture through the skin. This condition is slightly more common in women and African-Americans. It usually begins after you become a teenager and before age 40.

Causes

Hidradenitis suppurativa is caused when a duct in the body is blocked. Material traveling in the duct becomes backed up and infected. 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. The disorder usually occurs in adults who are otherwise healthy. It rarely begins before puberty or after menopause. Hidradenitis may become worse under stress. Hidradenitis is not caused by poor hygiene.

Symptoms

It is a non-contagious skin disease that usually appears on the body in skin folds of the underarms, groin, or perianal area. It has three main stages, beginning with boils or pockets of infection (abscesses). These become hard, painful, inflamed lumps with drainage (suppuration). Tunnels (sinus tracts) may form around and between the lumps. HS sufferers may go through severe bouts of depression, avoid public and inter-personal contact, become sedentary and often overweight.

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.

Treatment

Patients with Hidradenitis Suppurativa are advised to not delay their treatment. Talk with a doctor about current treatment options. Insist on appropriate pain relief. Discuss feelings of anxiety and depression that are so common to this disease.

Long-term use of oral and topical anti-inflammatory antibiotics such as those used in cases of severe acne, may stop inflammation. But be aware that long-term use of antibiotics cans gradually produce resistant bacteria and secondary yeast infections.

Surgical treatment of recurrent or severe symptoms involves removal of all involved skin followed by direct closure with skin flaps or with skin grafting (removing skin from one area of your body and attaching it to another). Full surgical removal of the affected areas can treat the disease that is present but doesn't prevent the disease from occurring in other areas.

Carbon dioxide laser treatment is a relatively new treatment for hidradenitis suppurativa. It is suitable for those with mild to moderate/severe disease and doesn’t require hospitalisation.

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