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Hidradenitis Suppurativa - Causes, Symptoms and Treatment

Definition:

It is a chronic skin disease that affects areas bearing apocrine sweat glands and hair follicles ; such as the underarms, groin and buttocks, and under the breasts in women.

Initially, they starts as one or more red, tender, swellings in the groin or axilla. But after few days, these lesions enlarge and often open to the skin surface draining all of its yellow fluid.

There are Mainly three Clinical Stages of Hidradenitis Suppurativa:

  • Stage 1: In the first stage, inflammation and pus is seen in single or multiple areas.
  • Stage 2: Single or multiple abscesses recur, possibly at widely separated areas of the body.
  • Stage 3: Here, throughout the area of the body, multiple abscesses develop.

Causes of Hidradenitis Suppurativa:

Some important causes of hidradenitis suppurativa are as:-

  • The main cause of hidreadenitis suppurativa is enlargement in the sweat (apocrine) glands, either by perspiration or because incomplete development makes it difficult for them to drain properly. The trapped fluids are then forced into the surrounding tissue, causing inflammation and infection.
  • Heredity: People who have acne, also genetically predisposed, are more likely to develop Hidradenitis Suppurativa.
  • Individuals with tightly curled hair, such as those of African ancestry, are also at an increased risk of developing Hidradenitis Suppurativa.
  • Stress, the onset of the menstrual period, extreme heat or excessive perspiration are the main causes of hidradenitis suppurativa.
  • The abnormality in the secretion of hormones, may lead to the condition of hidredenitis suppurativa.
  • A disorder of follicular occlusion, may result in hidradenitis suppurativa.
  • Endocrine Factors - obesity, hirsutism and acne are common findings among women with hidradenitis suppurativa.
  • Cigarette Smoking - Hidradenitis Suppurativa has been seen to appear more frequently in smokers than non-smokers.

Symptoms of Hidradenitis Suppurativa:

Some important symptoms are as:-

  • The inflammation of single or multiple areas and pus (abscesses) may be seen, which looks like acne.
  • The presence of hard lumps under the skin that are very painful to the touch and may persist for years. These lumps have the potential to become inflamed.
  • There are painful, rounded deep-rooted inflamed lumps. These sores heal either very slowly or do not heal at all, causing scarring. Bacterial infection is also possible.

Treatments of Hidradenitis Suppurativa:

Some Effective Treatments for Hidradenitis Suppurativa includes:-

  • Hidradenitis can be controlled, but cannot be cured properly. Sometimes surgery is required to drain infected areas or to remove scarred tissue or even large areas of skin.
  • Topical Antibiotics are one of the best treatment option for curing hidradenitis suppurativa fast. It is applied over the affected skin.
  • Retinoids: These have been shown to be effective in some chronic cases of hidradenitis suppurativa.
  • Weight loss will also help in controlling hidradenitis suppurativa.
  • High-dose systemic steroids (eg, prednisolone 60 mg/d) are useful as adjuvant's to antibiotics, and they act by reducing the inflammatory process.
  • Systemic Antibiotics are necessary when the condition is flaring or when a patient is undergoing a severe case of hidradenitis suppurativa.
  • Tight-fitting clothing is to be strictly avoided.
  • Contraceptive Pills and the combination of estrogens with 100 mg of cyproterone acetate have been used.
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