Hindradenitis Suppurative

Definition:
Hidradenitis is a chronic disease of the scent or apocrine glands which causes chronic scarring and pus formation of the axillae and groin areas. It is similar to acne which is a disease of the sebaceous glands. This condition is slightly more common in African-Americans and women. Hidradenitis usually starts as one or more red, tender, swellings in the groin or axilla. Over a period of hours to days the lesions enlarge and often open to the skin surface draining clear to yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission.

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Hidradenitis Suppurativa (HS), also known as ‘Acne Inversa‘, is a physically, psychologically, and socially disabling disease affecting inverse areas of the body (those places where there is skin-to-skin contact – armpits, groin, breasts, etc.), and where apocrine glands and hair follicles are found. It is non-contagious and recurrent; typically manifesting as a progression from single boil-like, pus-filled abscesses, or hard sebaceous lumps, to painful, deep-seated, often inflamed clusters of lesions with chronic seepage (suppuration — hence the name) involving significant scarring.

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Causes and Associations:

For unknown reasons, people with hidradenitis develop plugging or clogging of their apocrine glands. This leads to bacterial infection which can produce pain and odor.
Hidradenitis is made worse by being overweight, however this condition is not caused by obesity.

Hidradenitis is more common in people who have had acne.

Hidradenitis may become worse under stress.

Hidradenitis is not caused by poor hygiene.

Hidradenitis is a chronic disease of the apocrine glands (a form of sweat gland found on certain parts of the body). For unknown reasons, people with hidradenitis develop plugging or clogging of their apocrine glands. It causes chronic scarring and pus formation of the underarms (axilla) and groin/inner thigh areas. In women it can also occur under the breasts. It is similar to acne, which is also a disease of the sebaceous glands. Hidradenitis is more common in people who have had acne. It may be an unusual type of adult acne.

This condition is slightly more common in women and African-Americans. Hidradenitis usually starts as one or more red, tender, swellings in the groin or armpits. Over a period of hours to days the lesions enlarge and often open to the skin surface draining clear to yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission.

Bacterial infection produces the pain and odor. Hidradenitis is made worse by being overweight, however this condition is not caused by obesity and weight loss will improve but not cure hidradenitis. Hidradenitis may become worse under stress. Hidradenitis is not caused by poor hygiene.

Symptoms
Hidradenitis suppurativa usually develops in otherwise healthy people, but it has been associated with Crohn’s disease in some individuals. 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.

Scars form. The last stage is the most debilitating, because large areas of skin are affected by the abscesses, sinus tracts, lumps, and scars.


Worsens over time

Hidradenitis suppurativa usually develops slowly over time, with flare-ups, but in some people the disease progresses quickly. The course of the disease varies for each person. Some will stay at one stage most of the

Treatment:

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.

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.

Initial treatments are usually oral antibiotics (minocycline, tetracycline, erythromycin, Augmentin, others) and topical antibiotics (clindamycin or erythromycin). Intralesional injections into the affected places reduce swelling and tenderness within days. Anti-inflammatory pills (Celebrex, Advil, Naprosyn, Alleve, and others) are helpful in addition to the antibiotics, especially if it is a severe case. Some women respond to high estrogen birth control pills (Demulen 1/50 Ortho Novum 1/50) and spironolactone pills.

Tight fitting clothing and shaving the areas are to be strictly avoided. Dirt does not cause hidradenitis. The involved areas should be cleaned daily using an antibacterial soap, as this will reduce any odor associated with this condition. Retin-A cream, a prescription, helps some people. Accutane, a drug for severe acne, offers modest help for moderately bad cases. There is medical control, but not cure for hidradenitis.

Surgery is the most effective treatment for recalcitrant hidradenitis. Aggressive surgery will cure an area of severe, chronic hidradenitis but it has to remove scarred tissue or even large areas of skin. Skin grafts may be needed. Incision (lancing) and draining will reliably help smaller affected areas. Because surgery scars and may have complications, medical treatments are usually tried first.

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Molluscum (Official Info) – ZymaDerm is an F.D.A. approved
homeopathic remedy.
www.molluscum-contagiosum.net

Homeopathy & Hidradenitis Suppurativa

Click Here for Medical and Research Articles on Hidradenitis Suppurativa

Resources:
http://www.skinsite.com/info_hidradenitis_suppurativa.htm
http://www.aocd.org/skin/dermatologic_diseases/hidradenitis_suppu.html
http://www.hs-usa.org/hidradenitis_suppurativa.htm

http://rarediseases.about.com/cs/hidradenitissupp/a/072703.htm

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9 thoughts on “Hindradenitis Suppurative

  1. Pingback: Hindradenitis Suppurative — Pharmacy medicine shop

  2. tom

    i suffer from this horrible and embarassing recurring ailment. ive had it since i was 12 and i am 27 now. it SUCKS!!!!!!! nothing stops it. fat or skinny, one or two showers a day, it never goes away. its always there to knock my confidence right into the dirt. not to mention the pain is indescribable when i have 3-4 or more at a time. and dont forget about the friggin scars, the hundred scars on each inner thigh and along my pant line. gotta love it…..

    Reply
    1. stephany

      hey tom i believe i have hindradenitis.. i also have them on my inner thighs. My doctor has told me its mulluscum and has been treating it. But when i did research the bumps dont look really look like mulluscum they look like hindradentis. And they are hard and filled with pus just like the disease describes. When i mentioned to my doctor that i thought it was hidradentis, he said that hidradentis is more from shaving or something. He sounded pretty confident it was mulluscum but im kinda think it hindradentis. I was hoping by talking to somebody who has them in the same area might be able to help. im 22 and i recently gained weight during my pregnancy and thats when they first appeared, I only get 1-4 at a time and they last about 1-2 wks. and they leave a dull purpleish round scar. Then they randomly come and go. They feel hard underneath and hurt pretty bad when its in boil form. Does this sound like what you have? How were you diagnosed with it and did your doctor tell you why you have it? how do you treat it? and do you have any advice..

      Reply
  3. Kristina

    I have this same issue under my arms. I've been to the emergency room multiple times during flare ups and have spoken with numerous doctors about it. They always tell me it's because I'm overweight and push antibiotics down my throat. This has been going on since I was about 18. I'm 22 now, so I haven't been suffering with it long. But, it is extremely painful and embarrassing. There are times when I cannot lift my arms because they are hurting so bad. It especially sucks because the holes are opening one on top of the other and they are starting to connect and expand. I have to keep them bandaged pretty much all the time to cut down on the odor. I thought for sure I was the only one suffering with this and that no one knew what was going on with me. I wouldn't wish this on anyone, but I'm certainly glad I'm not alone.

    Reply
  4. Chuck walker

    I also have it and I am to glad I am not alone, this thing has affected my Life, marriage, work and confidence. I would rather have diabities this this crap! at least I would not what I am dealing with. I have it under my arms, between my legs and under my belt line. It hurts and wont stop! I am seeing a plastic surgeon in 2 weeks.

    Reply
  5. Lee

    I too have this dibilatating disease! Under my arms, between my legs, butt, and vaginal areas! EXTREMELY painful, I can have 9 or more at once! I have been livin with this disease for 18 yrs now, and have been mis-diagnosed for all of that time! It does kind of help to talk about it, to someone who actually understands.

    Reply
  6. verna

    I too am opaqued with terrible disease. I have it ALL over my body. My inner thighs are the worst. Big long purple scars I have it under my arms on my arms under my breast and big sores on top of my breasts on my groom on my buttocks area. I have taken every antibiotic there is plus accutane 3 times. Used every soap and cream known to man. Nothing seems to make even a small difference. I feel so UGLY! Don t feel normal. I feel like why me?

    Reply
  7. Jessica

    I have had this disease since I was 16, I am 22 now. I get it on my bum, armpits and other embarassing places. I used to do photography and modelling but it eventually got so bad that I had to give it all up. I can't wear a bikini down the beach, I'm too scared to even show my body to my husband. It really hurts me to know that there is no cure for this except drastic surgery which may not even fix the problem. Not only is it an extremely painful disease but it is emotionally painful because I never feel happy about myself. I am not glad that I am not alone as I would never wish this on anyone.

    Reply
  8. nikki

    I have been reading about this horrible disease and I KNOW that this is what’s wrong with me. I have been suffering with this since I was about 12 years old. I am now 25 and it has only gotten worse. I went to the doctor for it when I was 14 and she told me I needed to shower more. That they were pimples because I was dirty. I was already taking 2 showers a day then! I never saw another doctor about it I have been suffering in silence. Although now that I KNOW what this is and that there are ways to treat it I will as soon as I can get health insurance again. I have scars everywhere. I feel so ugly. I don’t want my husband to even look at me much less touch me. It’s ruining our marriage. Its ruining my life. I also feel like why me. Although I feel like that a lot as I have several other medical conditions that are also very painful. I wish everyone on her suffering with this God awful disease the best of luck. I wouldn’t wish this hell on my worst enemy.

    Reply

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