What is hidradenitis suppurative?

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Hidradenitis suppuritiva is a chronic inflammatory condition affecting areas of skin that bear apocrine grands ie. axillae (armpits), groins and under the breasts.

 

Boil-like nodules and abscesses appear. They discharge pus and form sinuses, eventually leading to scarring 

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What are the risk factors for HS?

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A family history of HS (40% of patients have a family history)

Obesity

Insulin resistance

Cigarette smoking

Follicular occlusion syndrome (acne, dissecting cellulitis, pilonidal sinus)

Inflammatory bowel disease eg Crohn's disease

Drugs: lithium

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What is the cause of HS?

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There is infllammation of the hair follicle wall, destroying sebaceous and apocrine glands and their ducts.

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What are the clinical features of HS?

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Comedones (blackheads)

Painful papules and nodules (red bumps)

Pustules

Abscesses

Draining sinuses

Hypertophic (thickened) and atopic (thin) scars

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Classification of HS by severity

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Stage I: Solitary or several isolated abscesses. No sinus tracts or scarring

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Stage II: Recurrent abscesses, single or multiple, widely spaced with sinus tract formation

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Stage iii:  Diffuse involvement, recurrent abscesses

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This page is under construction.

Photos to arrive soon

Treatment details to follow

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USEFUL LINKS

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Further reading: https://dermnetnz.org/topics/hidradenitis-suppurativa/

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HS_Foundation:  

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South African support group: