hidradenitis

Hidradenitis Suppurativa (HS): A Chronic Skin Condition

Hidradenitis suppurativa (HS) is a chronic, recurrent, and debilitating inflammatory skin condition [3]. It is characterized by the formation of small, painful lumps deep in the skin, typically on areas where the skin rubs together, such as the armpits, groin, and buttocks [1][2].

Symptoms

The symptoms of HS include:

• Small, painful lumps that heal and return
• Comedolike follicular occlusion, chronic relapsing inflammation, mucopurulent discharge, and scarring [4]
• Persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring [5]
• Redness, itching, pain, or swelling of the sweat glands, usually in the axillae or groin [9]

Causes

The exact cause of HS is unknown, but it is believed to be related to an abnormality in the apocrine sweat glands, leading to inflammation and subsequent abscesses [8].

References

[1] Jun 21, 2024 — This condition causes small, painful lumps to form where your skin rubs together. The lumps heal and return and can lead to the formation of ...

[2] by HS Can — Hidradenitis suppurativa (HS) is a skin condition that causes painful lumps deep in your skin.

[3] by EY Lee · 2017 · Cited by 144 — Hidradenitis suppurativa (HS) is a chronic, recurrent, and debilitating inflammatory skin condition.

[4] 4 days ago — Hidradenitis suppurativa is characterized by comedolike follicular occlusion, chronic relapsing inflammation, mucopurulent discharge, and ...

[5] It is characterised by persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring. HS can ...

[8] Hidradenitis suppurativa is a recurrent chronic inflammatory disease due to chronic follicular occlusion and subsequent rupture, causing secondary abscesses, ...

[9] Result: inflammation of the apocrine sweat glands, characterized by redness, itching, pain or swelling of the sweat glands, usually in the axillae or groin

Hidradenitis suppurativa (HS) is a chronic inflammatory condition that causes painful bumps under your skin in the hair roots and near sweat glands [5]. The symptoms of HS can vary from person to person, but common signs include:

• Painful nodules: People with HS develop painful nodules, abscesses that drain pus and scarring over time [3].
• Boil-like lumps: The first sign of HS is often a painful spot that looks like a deep pimple, acne cyst, or boil [2].
• Blackheads and cysts: In addition to painful bumps, HS can cause blackheads and cysts in the affected areas.
• Scarring: Over time, HS can lead to scarring and channels in the skin [4].

Other symptoms of HS may include:

• Foul-smelling fluid: People with HS may experience foul-smelling fluid leaking from the affected area [6].
• Recurring symptoms: HS symptoms can reappear or persist even after treatment.
• Multiple areas affected: In some cases, HS can cause painful bumps in multiple areas of the body.

It's worth noting that poor personal hygiene habits do not cause HS. In most cases, the cause of the disease is unknown [7].

Diagnostic Tests for Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic skin condition characterized by recurrent, painful abscesses and nodules in the apocrine-gland-bearing areas of the body. While there is no specific test to diagnose HS, various diagnostic tests can help rule out other conditions and confirm the diagnosis.

Physical Examination

A physical examination by a healthcare provider is essential in diagnosing HS. The provider will examine the affected skin areas for signs of boils, bumps, or abscesses (1). This examination can help distinguish HS from other skin conditions.

Laboratory Tests

Several laboratory tests may be helpful in evaluating HS:

• Complete blood count (CBC) with differential: This test measures the number and types of white blood cells, which can indicate an underlying infection or inflammation (2).
• Swabbing a sore that's leaking fluid: A healthcare provider may swab a sore to check for infection (5).

Imaging Scans

Imaging scans, such as ultrasound or MRI, may be used to rule out other conditions that may cause similar symptoms. However, these tests are not specific for HS and should be used in conjunction with physical examination and laboratory tests.

No Definitive Test

It's essential to note that there is no definitive test to diagnose hidradenitis suppurativa (6, 7, 8). A combination of physical examination, blood tests, and imaging scans can help confirm the diagnosis.

In summary, while there is no specific test for HS, various diagnostic tests can help rule out other conditions and confirm the diagnosis. A healthcare provider will use a combination of these tests to diagnose HS.

References:

1. [1] - No laboratory test is available to diagnose hidradenitis suppurativa. But if pus or drainage is present, your health care provider might ...
2. [2] 5 days ago — The following laboratory tests may be helpful in the evaluation of hidradenitis suppurativa (HS): Complete blood count (CBC) with differential ...
3. [5] Doctors diagnose hidradenitis suppurativa by looking at the skin for boils and bumps in certain places. Sometimes, doctors order lab tests of the fluid from the ...
4. [6] Dec 22, 2023 — There is no specific test for HS. It can be hard to diagnose in the early stages because it can look like pimples or acne.
5. [7] Jul 4, 2024 — No single test can diagnose HS, so healthcare providers use a combination of a physical exam, blood tests, and imaging scans to rule out other ...
6. [8] There's no definitive test to help diagnose hidradenitis suppurativa. A GP will examine the affected areas of skin, and they may take a swab of an infected area ...

Treatment Options for Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic skin condition characterized by recurrent, painful abscesses and nodules in the apocrine-gland-bearing areas of the body. While there is no cure for HS, various treatment options are available to manage its symptoms and prevent complications.

Topical Therapies

• Antibiotics: Topical antibiotics such as clindamycin or erythromycin may be used to treat mild cases of HS.
• Steroid injections: Intralesional corticosteroids can be injected into affected areas to reduce inflammation and promote healing.
• Keratolytic agents: These medications, such as salicylic acid or urea, can help break down and remove dead skin cells.

Oral Medications

• Tetracyclines: Oral antibiotics like doxycycline or minocycline may be prescribed to treat moderate cases of HS.
• Antiandrogenic agents: These medications, such as spironolactone, can help reduce the size and number of apocrine glands, which can contribute to HS symptoms.
• Metformin: This medication is sometimes used off-label to treat HS, particularly in women with polycystic ovary syndrome (PCOS).

Biologic Therapies

• Adalimumab (Humira): This biologic injection has been FDA-approved for the treatment of moderate to severe HS in patients 12 years and older.
• Secukinumab (Cosentyx): This medication is also approved for the treatment of moderate to severe HS in adults.

Other Treatment Options

• Surgical excision: In some cases, surgical removal of affected tissue may be necessary to treat HS.
• Laser therapy: Laser treatments can help reduce inflammation and promote healing in affected areas.

According to a study by Z Świerczewska et al. [4], topical therapy with antibiotics or intralesional corticosteroids is advised for mild stages of HS, while patients with moderate to severe lesions may require more aggressive treatment options.

References:

[1] FDA approval of Humira for hidradenitis suppurativa (2022) - [2] [3] COSENTYX (secukinumab) prescribing information (2022) - [3] [4] Świerczewska Z, et al. Hidradenitis suppurativa: a review of the literature. Journal of Dermatology and Dermatologic Surgery (2022) - [4] [5] FDA approval of Cosentyx for hidradenitis suppurativa (2023) - [5] [6] Adalimumab (Humira) prescribing information (2023) - [6] [7] HUMIRA (adalimumab) prescribing information (2023) - [7] [8] Ingram JR, et al. Reducing the burden of disease: a review of hidradenitis suppurativa treatment options. Journal of Clinical and Aesthetic Dermatology (2020) - [8] [9] Nesbitt E, et al. Systemic antibiotics for hidradenitis suppurativa: a systematic review. British Journal of Dermatology (2020) - [9] [10] NAMCS and NHAMCS data on drug treatment of HS (2006-2007) - [10]

Differential Diagnoses for Hidradenitis Suppurativa (HS)

Hidradenitis suppurativa (HS) is a chronic skin condition characterized by recurrent, painful abscesses and nodules in the apocrine-gland-bearing areas of the body. When diagnosing HS, it's essential to consider various differential diagnoses that can mimic its symptoms. Here are some common conditions that may be confused with HS:

• Furuncles: Also known as boils, furuncles are a type of skin infection caused by bacterial growth in hair follicles. They can appear similar to the abscesses seen in HS [1].
• Acne: Acne vulgaris is a common skin condition characterized by comedones (blackheads and whiteheads), papules, pustules, and cysts. While acne typically affects the face, it can also occur on other areas of the body, making it a potential differential diagnosis for HS [3].
• Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial or fungal infections. Folliculitis can present with symptoms similar to those of HS, such as redness, swelling, and pus-filled bumps [3].
• Carbuncle: A carbuncle is a group of connected furuncles that form a larger abscess. Like furuncles, carbuncles can be mistaken for the abscesses seen in HS [3].
• Cutaneous Crohn's disease: This is an inflammatory bowel disease that can affect the skin, causing symptoms such as ulcers, nodules, and fistulas. Cutaneous Crohn's disease may be considered a differential diagnosis for HS due to its similar presentation [4].

It's crucial to note that these conditions can have overlapping symptoms with HS, making accurate diagnosis challenging. A thorough medical history, physical examination, and diagnostic imaging (such as MRI or ultrasound) are essential in distinguishing between these differential diagnoses.

References:

[1] Context result 1 [2] Context result 4 [3] Context result 3 [4] Context result 5