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HIDRADENITIS

Introduction:

Hidradenitis is any disease in which the histologic abnormality is primarily an inflammatory infiltrate around the eccrine glands. This group includes neutrophilic eccrine hidradenitis and recurrent palmoplantar hidradenitis.


It can also be defined more generally as an inflammation of sweat glands.

Hidradenitis suppurativa is a chronic cutaneous condition originally thought to be primarily characterized by suppurative inflammation of the apocrine sweat glands. Recent evidence supports that the primary event is follicular hyperkeratosis and obstruction.

Signs and Symptoms:


Hidradenitis suppurativa is a chronic inflammatory skin condition, considered a member of the acne family of disorders. It is sometimes called acne inversa. The first signs of HS are small bumps on the skin that resemble pimples, cysts, boils, or folliculitis. As the disease progresses and abscesses reoccur, they become larger and more painful; eventually tunnels of scar tissue connect the lesions. These lesions may open up if they become too enlarged and drain bloodstained pus. 



Pathogenesis:


One risk factor is age; HS usually first appears during the 20s and early 30s. The condition is much more common in women than in men but is usually more serious and debilitating in men. Other associated conditions include obesity, diabetes, metabolic syndrome, arthritis, acne, and other inflammatory disorders. Early diagnosis of this disease is very important to decrease the number of flares, pain, and discomfort. 



Treatment:

The Mayo Clinic suggests the following: antibiotics (generally the lowest side effect profile compared to other treatments); corticosteroids (e.g., prednisone); but corticosteroids have many side effects, including "moon face" for the duration of the medication's trial usage, as well as unwanted hair growth for females and/or osteoporosis with long-term use. Tumor necrosis factor (TNF)-alpha inhibitors like infliximab (Remicade) and adalimumab (Humira) have shown promise for some, but they should probably be considered a third-line treatment, as treatment is associated with increased risk of infection, heart failure and certain cancers. Surgery is also available for those overwhelmed by the condition, but it will not cure the condition, just relieve the skin-related issues for a while. 


Top UK Dermatologists Online Consultation
Source: https://en.wikipedia.org/wiki/Hidradenitis

For more information on this topic please click on the links below

Link to British Association of Dermatologists article on dermatology from DermUK
Link to DermNet NZ article on dermatology from DermUK
Link to Medscape dermatology article from DermUK


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