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Hidradenitis Suppurativa

Hidradenitis suppurativa is a chronic pyogenic infection of the apocrine sweat glands of the axillae, less so, of the breast, genitalia or peri-anal region. Hyperhidrosis, obesity, lack of fresh air, irritation by clothing, shaving, use of depilatories or the presence of intertrigo, are the predisposing causes; Staphylococcus aureus is presumably the causative organism. 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. The condition usually continues for years with periods of flare and remission. The disease is variable and recurrent. Patients may present with solitary or multiple lesions in one area, with lesions in many areas, or in more severe cases may have large, recurrent, draining lesions that never completely heal. Three distinct clinical stages have been defined for the condition.

  • Stage 1: Solitary or multiple, isolated abscess formation without scarring or sinus tracts
  • Stage 2: Recurrent abscesses, single or multiple widely separated lesions, with sinus tract formation
  • Stage 3: Diffuse or broad involvement, with multiple interconnected sinus tracts and abscesses.

Hidradenitis Suppurativa Causes

HS causes painful and chronically recurring, deep-seated follicular nodules, papules, pustules and abscesses, leading to suppuration, fibrosis, and scarring of the skin.The cause is unknown but it is commoner in females, and within some families it appears to be inherited in an autosomal dominant fashion. Clinically it presents after puberty with papules, nodules and abscesses which often progress to cysts and sinus formation. With time, scarring may arise. The condition follows a chronic relapsing/remitting course. 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.

Hidradenitis Suppurativa 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.

Hidradenitis SuppurativaTreatment

Although this disease is not proper curable but there is a lot of treatments which are used to reduce this disease. 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. There are many treatment of Hidradenitis Suppurativa, some of them are as follows:

  • There is no medical cure for hidradenitis. Hidradenitis can be controlled, but not cured. Sometimes surgery is required to drain infected areas or to remove scarred tissue or even large areas of skin.
  • Weight loss will improve but not cure hidradenitis
  • 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.
  • Dirt does not cause hidradenitis. The involved areas should be cleaned daily using an antibacterial soap, such as the liquid form of Lever 2000. Some patients have found that the liquid form of Lever 2000, applied to the involved areas as a lotion after bathing, can help reduce the odor associated with this condition.
 
 

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