Hidradenitis Suppurativa

What is Hidradenitis Suppurativa?

Hidradenitis suppurativa is a skin condition that is characterized by small painful bumps underneath the skin near to sweat glands. These bumps can also develop where your skin rub together such as under the breast in women and between the thighs.⁴

Apocrine gland is a type of sweat gland, which is located in area where there is hair on your body such as groin, between the buttocks and armpits. Hidradenitis suppurativa develops in the aforementioned areas.

These bumps can get infected. When this occurs, pockets of pus forms under your skin and can burst open and release a bad smell and even form tunnels under the skin. This may leave scars on your skin.

This condition begins after adolescent or puberty and can continue for many years as well as become worse. This causes serious effects on your daily activities and emotional healthy.

Causes

There is no known cause of this condition. However, hidradenitis suppurativa develops when sweat glands get obstructed. This condition is not caused by poor levels of hygiene and can’t be transmitted sexually. It is also not contagious¹.

Risk Factors

Several factors can elevate your risk of getting hidradenitis suppurativa. They include:²

• Gender: If you are a woman, you are more likely to get Hidradenitis Suppurativa than men.
• Age: This condition affects women who are between 20- 29 years.
• Family history: A person who comes from a family where members have hidradenitis suppurativa is more likely to inherit this condition.
• Smoking: Smoking cigarette is also associated with hidradenitis suppurativa.
• Other health conditions: Hidradenitis suppurativa can be linked to other medical conditions such as acne, diabetes, arthritis, inflammatory bowel disease, etc.

Symptoms

Patients with hidradenitis suppurativa can have the following symptoms:²

Patients have small bumpy skin which appears in pairs. These bumps are red and soft when touched. The bumps widen and can burst releasing pus which may have an odor like smell. You may also experience burning and itching in the affected areas.

In some cases, hard painful bumps can form in the affected areas, continue for many years, and become bigger and inflamed. After some time, tunnels starts to form below the skin and may contain pus.

This condition begins at puberty and at the age of 40 years as a solitary painful bump on the skin which continues for several weeks. In some people, this condition can worsen and spreads to other areas of the body. Other people may experience symptoms of this condition which are not severe.

Too much weigh, stress and changes in hormones can aggravate this symptoms. In women, when they are past menopause, these symptoms may diminish.

When to Seek Treatment?

You can see your doctor if you experience the following: your condition

• Is painful
• Occurs is several areas of your body
• Recurs frequently
• There is no change after several weeks

Diagnosis

To diagnose Hidradenitis suppurativa, your doctor will discuss with you the symptoms you are experiencing and your past health history. Then the doctor physically examines your affected skin so as to understand this condition.³

Normally, no laboratory tests are needed. However, if you have pus, your doctor may take a sample of the fluid and assess it in the laboratory to exclude other skin infections.

Treatment

Hidradenitis suppurativa has no cure. But beginning treatment early enough can help manage this condition and promote healing as well as prevent any complication that may emerge.¹

There are a number of treatment methods available to treat hidradenitis suppurativa. You should talk with your doctor to find which treatment option is most suitable for you. The following are some of the treatment your doctor can recommend:

Medications

There are several medications your doctor can prescribe to treat this condition. They include:

• Use of antibiotics and drugs obtained from Vitamins A to treat infections in the affected area
• Your doctor can inject in the affected area steroid to lower inflammation. You can also use prednisone but this drug may cause you to develop osteoporosis.
• You will also be given pain relieving drugs such as morphine, pregabalin and codeine.

Surgery

Your doctor can also use surgery interventions to treat this condition. There are many surgery procedure to use but this depends on the where the wound is and it’s extend. Your doctor may use the following:

Unroofing

In this procedure, your doctor removes the skin and flesh covering the interconnected tunnels on your skin. In case, there is only one inflamed nodule on your skin, your doctor conducts a procedure known as mini roofing to remove it.

Surgical drainage

When the affected area is small, your doctor can use this procedure to drain out fluid. This method provides pain relief for only a short period of time and sore may recur.

Tissue sparing excision with electrosurgery

This procedure is only used for patients who have severe hidradenitis suppurativa. It is used to remove dead tissues and keep healthy ones. In this procedure, you will be under a general anesthesia so that you do not feel pain during the operation.

Surgical removal

For recurrent symptoms, your doctor performs surgery to completely remove all involved skin and grafts the wound.

Home remedies

Mild symptoms of hidradenitis suppurativa can be treated with self- care measures. These measures include:

• Wash your body with a nonsoap cleanser. Avoid substances that irritate your skin.
• Apply teabags on the affected area to compress it and reduce swelling and relieve pain.
• Wear lose clothing’s to avoid your skin rubbing to the cloth which can irritate the skin.
• Avoid squeezing the pimples or sores because doing this may cause an infection in the affected area.
• Quit smoking.

Complications

Hidradenitis suppurativa can be persistent and severe and cause several undesirable complications such as:¹

• Infections: The bumps on your skin can get infected from viruses and bacteria.
• Scarring: The infected bumps can break open and leave scars on the affected skin.
• Limited movement: When scars occur in your thighs and armpits, they restrict movement since it’s painful to move your arm or thighs.
• Social seclusion: When the bumps are infected, they smell bad and can embarrass you. This makes you unwilling to go out and interact with friends. As a result of loneliness, a person can become depressed.
• Blockage of lymph drainage: The areas where Hidradenitis suppurativa occurs have lymph nodes. When there are scars in those areas, they may block lymph nodes there which may lead to swellings in the legs, arms and genitals.
• Cancer: It is very rare for patients with hidradenitis suppurativa to develop cancer from the affected skin.

Pictures

Reference List

1. Symptoms and Causes of Hidradenitis Suppurativa. Available at http://emedicine.medscape.com/article/1073117-overview
2. Treatment of Hidradenitis Suppurativa. Available at http://www.webmd.com/skin-problems-and-treatments/hidradenitis-suppurativa#2
3. http://www.hs-foundation.org
4. https://medlineplus.gov/hidradenitissuppurativa.html
5. Hidradenitis suppurativa. Available at http://www.healthline.com/health/hidradenitis-suppurativa