Tag Archives: Cutaneous condition

Xanthoma

Other Names: Skin growths – fatty; Xanthelasma

Description:
A xanthoma, from Greek xanthos, “yellow”, is a deposition of yellowish cholesterol-rich material that can appear anywhere in the body in various disease states.It is a skin condition in which certain fats build up under the surface of the skin. They are cutaneous manifestations of lipidosis in which lipids accumulate in large foam cells within the skin. They are associated with hyperlipidemias, both primary and secondary types.

Tendon xanthomas are associated with type II hyperlipidemia, chronic biliary tract obstruction, and primary biliary cirrhosis. Palmar xanthomata and tuboeruptive xanthomata (over knees and elbows) occur in type III hyperlipidemia.

Types:
Xanthelasma:
A xanthelasma is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Strictly, a xanthelasma is a distinct condition, only being called a xanthoma when becoming larger and nodular, assuming tumorous proportions. Still, it is often classified simply as a subtype of xanthoma.

Xanthoma tuberosum:
Xanthoma tuberosum (also known as tuberous xanthoma) is characterized by xanthomas located over the joints.

Xanthoma tendinosum:
Xanthoma tendinosum (also tendon xanthoma or tendinous xanthoma) is clinically characterized by papules and nodules found in the tendons of the hands, feet, and heel. Also associated with familial hypercholesterolemia (FH).

Eruptive xanthoma:
Eruptive xanthoma (ILDS E78.220) is clinically characterized by small, yellowish-orange to reddish-brown papules that appear all over the body. It tends to be associated with elevated triglycerides.

Xanthoma planum:
Xanthoma planum (ILDS D76.370), also known as plane xanthoma, is clinically characterized by macules and plaques spread diffusely over large areas of the body.

Palmar xanthoma:
Palmar xanthoma is clinically characterized by yellowish plaques that involve the palms and flexural surfaces of the fingers.  Plane xanthomas are characterised by yellowish to orange, flat macules or slightly elevated plaques, often with a central white area which may be localised or generalised. They often arise in the skin folds, especially the palmar creases. They occur in hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia.

Tuberoeruptive xanthoma:
Tuberoeruptive xanthoma (ILDS E78.210) is clinically characterized by red papules and nodules that appear inflamed and tend to coalesce.[2]:532 Tuberous xanthomata are considered similar, and within the same disease spectrum as eruptive xanthomata.

Symptoms:
A xanthoma looks like a yellow to orange bump (papule) with defined borders.

Xanthomas are common, especially among older adults and people with high blood lipids.

Xanthomas vary in size. Some are very small. Others are bigger than 3 inches in diameter. They appear anywhere on the body, but are most often seen on the elbows, joints, tendons, knees, hands, feet, or buttocks.

Causes:
Xanthomas may be a sign of a medical condition that involves an increase in blood lipids. Such conditions include:

*Certain cancers
*Diabetes
*Hyperlipidemia
*Inherited metabolic disorders such as familial hypercholesterolemia
*Primary biliary cirrhosis
*Pancreatitis
*Hypothyroidism

Xanthelasma palpebra, a common type of xanthoma that appears on the eyelids and may occur without any underlying medical condition, is not necessarily associated with elevated cholesterol or lipids.

Diagnosis:
Your health care provider will examine the skin. Usually, a diagnosis of xanthoma can be made by looking at your skin. A biopsy of the growth will show a fatty deposit.

You may have blood tests done to check lipid levels, liver function, and for diabetes.

Treatment:
If you have a disease that causes increased blood lipids, treating the condition may help reduce the development of xanthomas.

If the growth bothers you, your doctor may remove it. But xanthomas may come back after surgery.

Prognosis:
The growth is non-cancerous and painless, but may be a sign of another medical condition.

Prevention:
Control of blood lipids, including triglycerides and cholesterol levels, may help reduce development of xanthomas.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/001447.htm
http://en.wikipedia.org/wiki/Xanthoma
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Sphaeralcea coccinea

Botanical Name : Sphaeralcea coccinea
Family: Malvaceae
Subfamily: Malvoideae
Genus: Sphaeralcea
Species: S. coccinea
Kingdom: Plantae
Order: Malvales

Synonyms: Malvastrum coccineum

Common Names; Scarlet Globemallow, Alkali Heath, red false globemallow, copper mallow

Habitat : Sphaeralcea coccinea is native to grasslands and prairies of the Great Plains and western regions of northern North America.

Description;
Sphaeralcea coccinea is a perennial plant growing 10–30 cm tall from spreading rhizomes with a low habit. They have grayish stems with dense, star-shaped hairs and alternately arranged leaves. The leaf blades are 2–5 cm long, palmately shaped, and deeply cut, with 3–5 main wedge-shaped segments. The undersides of the leaves have gray hairs. The 2-cm-wide flowers are reddish-orange and saucer-shaped, with 5 notched, broad petals, in small terminal clusters. Plants flower from May to October.Fruits are cheese-shaped capsules composed of 10 or  more 1-seeded carpels. Each carpel about 3 mm long, densely hairy on the back, net-veined on about 90% of the sides.

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Medicinal Uses:
This plant’s Navajo name came from the sticky mixture that occurs when the roots and leaves are pounded and soaked in water.  The resulting sticky infusion is put on sores to stop bleeding and is used as a lotion for skin disease.  The dried powdered plant is used as dusting powder.  It is one of the life medicines and is used as a tonic to improve the appetite, and to cure colds, coughs and flu.  The roots were used to stop bleeding, and they were also chewed to reduce hunger when food was scarce. The leaves are slimy and mucilaginous when crushed, and they were chewed or mashed and used as poultices or plasters on inflamed skin, sores, wounds and sore or blistered feet. Leaves were also used in lotions to relieve skin diseases, or they were dried, ground and dusted on sores.  Fresh leaves and flowers were chewed to relieve hoarse or sore throats and upset stomachs. Whole plants were used to make a sweet-tasting tea that made distasteful medicines more palatable. It was also said to reduce swellings, improve appetite, relieve upset stomachs, and strengthen voices. The Dakota heyoka chewed the plants to a paste and rubbed it on their skin as protection from scalding.  The tea is very effective for a raspy, dry, sore throat; and, like its relative Malva, it will soothe the urinary tract when urination is painful.  The tea is used for bathing infants to prevent or retard thrush, and to soothe chafing.  It is soothing to almost any skin rash in adults and children.  Strong decoction, 4-6 fluid ounces up to 4 times a day for internal use, as needed externally.

Disclaimer:The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider

Resources:
http://en.wikipedia.org/wiki/Sphaeralcea_coccinea
http://montana.plant-life.org/species/sphaer_cocc.htm
http://www.conps.org/slide%20shows/foothills%20wildflowers%20in%20the%20metro-denver%20chapter%20area/pages/sphaeralcea%20coccinea.htm
http://www.wildflower.org/plants/result.php?id_plant=SPCO
http://www.herbnet.com/Herb%20Uses_AB.htm

http://www.fs.fed.us/database/feis/plants/forb/sphcoc/all.html

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Varicose veins

 

Definition:
Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That’s because standing and walking upright increases the pressure in the veins of your lower body.

Varicose veins affect 1 out of 2 people over age 50. They are more common in women than men. Hemorrhoids are a type of varicose vein. Spider veins are like varicose veins, but they are smaller.

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems. Varicose veins may also signal a higher risk of other circulatory problems. Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

Symptoms:
Varicose veins usually don’t cause any pain. Signs you may have varicose veins include:

*Veins that are dark purple or blue in color
*Veins that appear twisted and bulging; often like cords on your legs
*Varicose veins may also form in other places on your legs, from your groin to your ankle.

CLICK & SEE THE PICTURES
When painful signs and symptoms occur, they may include:

*An achy or heavy feeling in your legs
*Burning, throbbing, muscle cramping and swelling in your lower legs
*Worsened pain after sitting or standing for a long time
*Itching around one or more of your veins
Skin ulcers near your ankle, which can mean you have a severe form of vascular disease that requires medical attention . Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue. They occur on the legs, but can also be found on the face. Spider veins vary in size and often look like a spider’s web.

Diagnosis:Ultrasound – Venous (Extremities)

When to call health care provider
Self-care — such as exercise, elevating your legs or wearing compression stockings — can help you ease the pain of varicose veins and may prevent them from getting worse. But if you’re concerned about how your veins look and feel and self-care measures haven’t stopped your condition from getting worse, see your doctor.


Causes:

Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity. Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward.

Causes of varicose veins can include:

*Age. As you get older, your veins can lose elasticity causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward. Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.

*Pregnancy. Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in your legs. Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs. Changes in your hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment within three months after delivery.

Risk factors:
These factors increase your risk of developing varicose veins:

*Your age. Varicose veins occur most often in people ages 30 to 70, with your risk increasing as you age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow blood to flow back into your veins where it collects instead of flowing up to your heart.

*Your sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.

*Genetics. If other family members had varicose veins, there’s a greater chance you will too.

*Obesity. Being overweight puts added pressure on your veins.

*Standing for long periods of time. Your blood doesn’t flow as well if you’re in the same
position for long periods.

Complications:-
Complications of varicose veins, although rare, can include:
Ulcers. Extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are caused by long-term fluid buildup in these tissues, caused by increased pressure of blood within affected veins. A brown colored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you’ve developed an ulcer.

Blood clots. Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may swell considerably. Any sudden leg swelling warrants urgent medical attention because it may indicate a blood clot — a condition known medically as
thrombophlebitis.

Treatment :
*Ambulatory Phlebectomy(American Society for Dermatologic Surgery)

*Sclerotherapy(American Society of Plastic Surgeons)

*Varicose Vein Treatment (Endovenous Ablation of Varicose Veins)(Radiological Society of North America)

*Vain Treatment: What to Expect Before, During, and After(American Academy of Dermatology)

Alternative Therapy :-
*Bilberry(National Center for Complementary and Alternative Medicine)
*Horse Chestnut(National Center for Complementary and Alternative Medicine)

Click to learn more about Varicose veins

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:

http://www.mayoclinic.com/health/varicose-veins/DS00256

http://www.nlm.nih.gov/medlineplus/varicoseveins.html

Seborrhoeic Dermatitis

Definition:
Seborrheic dermatitis is a common skin disorder that mainly affects the scalp, causing scaly, itchy, red skin and stubborn dandruff. For infants, seborrheic dermatitis of the scalp is known as cradle cap. In addition to the scalp, seborrheic dermatitis can also affect the face, upper chest, back and other oily areas of the body.

It’s neither harmful nor contagious, but seborrheic dermatitis can be uncomfortable and unsightly. You may be able to treat seborrheic dermatitis yourself by recognizing its signs and symptoms and by using a combination of self-care steps and over-the-counter (nonprescription) medications.

Seborrhoeic dermatitis or Seborrhoeic eczema is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin.

Symptoms:
Common signs and symptoms of seborrheic dermatitis include:

*Patchy scaling or thick crusts on the scalp
*Yellow or white scales that may attach to the hair shaft
*Red, greasy skin covered with flaky white or yellow scales
*Small, reddish-brown bumps
*Itching or soreness
*Skin flakes or dandruf

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..(01)........(1)....(2)..………(3)..….
Nasolabial fold scaling and erythema from seborrheic dermatitis.

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Severe persistent seborrheic dermatitis of the inframammary folds.

Seborrheic dermatitis predominately affects the scalp but can occur between folds of skin and on skin rich in oil glands. These include in and between your eyebrows, the sides of your nose and behind your ears, over your breastbone, your groin area, and sometimes your armpits. You may experience periods when your signs and symptoms improve alternating with times when they become worse.

In infants, seborrheic dermatitis of the scalp is known as cradle cap. The patches may be thick, yellow, crusty or greasy. In most cases, the condition isn’t itchy for infants like it is for older children or adults.

Side Effects:

Hair loss

Side effects to inflammation may include temporary hair loss. If severe outbreaks go untreated for long periods of time, permanent hair loss may result due to damaged hair follicles.

Expect two to six months before hair growth may resume.

Causes:
Though the exact cause of seborrheic dermatitis isn’t known, several contributing factors seem to play a role, including an abnormality of the oil glands and hair follicles. People with this disorder seem to have increased oil (sebum) production.

It’s also thought that in some people, a yeast (fungus) called malassezia grows in the sebum along with bacteria. Antifungal treatments, such as ketoconazole (Nizoral), are often effective, supporting the idea that yeast is a contributing factor.

Outbreaks may be linked with production of certain hormones, physical stress, fatigue, travel, change of season — outbreaks are usually worse in the winter — or illness. Seborrheic dermatitis may also occur more frequently in people who have neurological conditions, such as Parkinson’s disease.

Seborrheic dermatitis may also accompany acne rosacea, an inflammatory skin condition that causes redness of the face. However, the vast majority of people with seborrheic dermatitis have no other associated skin conditions.

The widely present yeast, Malassezia furfur (formerly known as Pityrosporum ovale), is involved, as well as genetic, environmental, hormonal, and immune-system factors. A suggestion that seborrhoeic dermatitis is an inflammatory response to this yeast has yet to be proven. Those afflicted with seborrhoeic dermatitis have an unfavourable epidermic response to the infection, with the skin becoming inflamed and flaking.

In children, excessive vitamin A intake can cause seborrhoeic dermatitis. Lack of biotin, pyridoxine (vitamin B6) and riboflavin (vitamin B2) may also be a cause.

Diagnosis:
Your doctor may diagnose seborrheic dermatitis after talking to you about your symptoms and examining your skin and scalp. Sometimes, a skin biopsy or other tests are necessary to confirm the diagnosis and to rule out other types of dermatitis.

Conditions that are similar to seborrheic dermatitis include:

*Atopic dermatitis. This form of dermatitis is a chronic condition that causes itchy, inflamed skin. Most often, it occurs in the folds of the elbows, backs of the knees or the front of the neck. It tends to flare periodically and then subside for a time, even up to several years.

*Psoriasis. A skin disorder characterized by dry, red, skin covered with silvery scales. Like seborrheic dermatitis, psoriasis can affect the scalp and cause flaky dandruff. Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas of the body.

*Ringworm of the scalp (tinea capitis). Ringworm of the scalp is a type of fungal infection that is most common in toddlers and school-age children. It causes red, itchy, bald-looking patches on the scalp.

Treatments:
There’s no cure for seborrheic dermatitis, but treatments can control its signs and symptoms. Treatment depends on your skin type, the severity of your condition and where it appears on your body.

Soaps and detergents such as sodium laureth sulfate may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition. Accordingly a suitable alternative should be used instead.

Among dermatologist recommended treatments are shampoos containing coal tar, ciclopiroxolamine ketoconazole, selenium sulfide, or zinc pyrithione. For severe disease, keratolytics such as salicylic acid or coal tar preparations may be used to remove dense scale. Topical terbinafine solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea, as may lotions containing alpha hydroxy acids or corticosteroids. Pimecrolimus topical lotion is also sometimes prescribed.

Chronic treatment with topical corticosteroids may lead to permanent skin changes, such as atrophy and telangiectasia.

UV-A and UV-B light inhibit the growth of M. furfur, although caution should be taken to avoid sun damage.

Those with seborrhoeic dermatitis might benefit from biotin supplements. One might also try a humidifier by the bed, as well as a gentle moisturizer with or without oatmeal.

Medicated shampoos are the first step in treating seborrheic dermatitis of the scalp. Choose an over-the-counter shampoo that contains one of the following ingredients:

  • Ketoconazole
  • Tar
  • Pyrithione zinc
  • Selenium sulfide
  • Salicylic acid

Try using the shampoo daily until your symptoms are controlled, then cut back to two or three times a week. If one type of shampoo works for a time and then seems to lose its effectiveness, try alternating between two types of dandruff shampoos. Be sure to leave the shampoo on for at least five minutes — this allows the ingredients time to work.

Plant-based (Herbal)treatments
Click to see :-> phytotherapy
The World Health Organization mentions Aloe vera gel as a yet to be scientifically proven traditional medicine treatment for Seborrhoeic dermatitis.

*Arctium lappa (Burdock) oil
*Chelidonium majus (Celandine)
*Glycyrrhiza glabra (Licorice)
*Melaleuca (Tea tree) species
*Plantago (Plantain) species
*Symphytum officinale (Comfrey)
*Zingiber officinale (Ginger) root juice

Self-care:
The following over-the-counter treatments and self-care tips can help you control and manage seborrheic dermatitis.

*Shampoo daily. Use an anti-dandruff shampoo that contains selenium sulfide, tar, pyrithione zinc, salicylic acid or ketoconazole as the active ingredient. Use a different shampoo with varying active ingredients each week for three weeks. Then repeat the rotation.

*Use an over-the-counter antifungal cream. Daily application of nonprescription clotrimazole (Lotrimin) may be helpful.

*Apply an anti-itch cream or lotion to the affected area. A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch.

*Avoid harsh soaps and detergents. Be sure to rinse the soap completely off your body.

*Wear smooth-textured cotton clothing. This will help you avoid irritation.

*Avoid scratching whenever possible. Cover the itchy area with a dressing, if you can’t keep from scratching it. Trim nails and wear gloves at night.

Cradle cap:
Cradle cap usually clears up on its own within a few months. In the meantime, wash your baby’s hair once a day with mild baby shampoo. Loosen the scales with a small, soft-bristled brush before rinsing off the shampoo.

If the scales don’t loosen easily, rub a few drops of mineral oil onto your baby’s scalp. Let the oil soak into the scales for a few minutes, and then brush and shampoo your baby’s hair as usual. If you leave the oil in your baby’s hair, it may only allow more scales to accumulate on your baby’s scalp.

If cradle cap persists or seems severe, your doctor may suggest a medicated (antifungal) shampoo, lotion or other treatment.

Click to learn more about Seborrhoeic Dermatitis….……………………(1)..………(2)

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Sources:
http://en.wikipedia.org/wiki/Seborrheic_dermatitis
http://www.mayoclinic.com/health/seborrheic-dermatitis/DS00984/DSECTION=1

Hidradenitis Suppurativa

Definition:
Hidradenitis suppurativa or HS is a skin disease that affects areas bearing apocrine sweat glands and hair follicles; such as the underarms, groin and buttocks. It is more commonly found in women and can be present under the breasts.

Hidradenitis suppurativa is a chronic skin inflammation marked by the presence of blackheads and one or more red, tender bumps (lesions). The lesions often enlarge, break open and drain pus. Scarring may result after several occurrences.

The cause of hidradenitis suppurativa isn’t known. But it’s considered a severe form of acne (acne inversa) because it occurs deep in the skin around oil (sebaceous) glands and hair follicles. The parts of the body affected — the groin and armpits, for example — are also the main locations of apocrine sweat glands.

Click to see pictures…>..(1)….…(2).……..(3).……...(4).…….(5)……..(6)……….…(7)

Hidradenitis suppurativa tends to start after puberty, persist for years and worsen over time. There is no cure for hidradenitis suppurativa. But early diagnosis and treatment can help manage the symptoms and prevent new lesions from developing.

Other names for HS
Hidradenitis suppurativa has been referred to by multiple names in the literature, as well as in various cultures. Some of these are also used to describe different diseases, or specific instances of this disease.

*Acne conglobata – not really a synonym – this is a similar process but in classic acne areas of chest and back

*Acne Inversa (AI) – a new term which has not found favour.

*Apocrine Acne – a misnomer, out-dated, based on the disproven concept that apocrine glands are primarily involved

*Apocrinitis – another misnomer, out-dated, based on the disproven concept that apocrine glands are primarily involved

*Fox-den disease – a catchy term not used in medical literature, based on the deep fox den / burrow – like sinuses

*Hidradenitis Supportiva – a misspelling

*Pyodermia sinifica fistulans – an older term, considered archaic now, misspelled here

*Velpeau’s disease – commemorating the French surgeon who first described the disease in 1833

*Verneuil’s disease – recognizing the French surgeon whose name is most often associated with the disorder as a result of his 1854-1865 studies

Stages
HS presents itself in three stages.

1.Solitary or multiple isolated abscess formation without scarring or sinus tracts. (A few minor sites with rare inflammation; may be mistaken for acne.)

2.Recurrent abscesses, single or multiple widely separated lesions, with sinus tract formation. (Frequent inflammations restrict movement and may require minor surgery such as incision and drainage.)

3.Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses. (Inflammation of sites to the size of golf balls, or sometimes baseballs; scarring develops, including subcutaneous tracts of infection – see fistula. Obviously, patients at this stage may be unable to function.)
Sign and Symptoms:

Hidradenitis suppurativa commonly occurs around hair follicles where many oil and sweat glands are found, such as the armpits, groin and anal area. It may also occur in areas where skin rubs together, such as the inner thighs, under the breasts or between the buttocks. Hidradenitis suppurativa can affect a single area or multiple areas of the body.

Click to  SEE THE PICTURES
Hidradenitis suppurativa usually appears as one or more red, tender bumps that fill with pus. It commonly occurs where oil (sebaceous) and apocrine sweat glands are found, such as the armpits, groin and anal area.

 

Signs and symptoms of hidradenitis suppurativa include:

*Small pitted areas of skin containing blackheads, often appearing in pairs or a “double-barrel” pattern.

*One or more red, tender bumps (lesions) that fill with pus. The bumps often enlarge, break open and drain pus. The drainage may have an unpleasant odor. Itching, burning and excessive sweating may accompany the bumps.

*Painful, pea-sized lumps that grow under the skin. These hard lumps, which may persist for years, can enlarge and become inflamed.

*Painful bumps or sores that continually leak fluid. These open wounds heal very slowly, if at all, often leading to scarring and the development of tunnels under the skin.

For some people, the disease progressively worsens and affects multiple areas of their body. Other people experience only mild symptoms. Excess weight, stress, hormonal changes, heat or excessive perspiration can worsen symptoms.

Causes:
Hidradenitis suppurativa develops when the oil glands and hair follicle openings become blocked. When oils and other skin products become trapped, they push into surrounding tissue. Bacteria can then trigger infection and inflammation. It’s not known why this occurs, but a number of factors — including hormones, genetics, cigarette smoking and excess weight — may all play a role.

Sometimes hidradenitis suppurativa occurs with other diseases, such as Crohn’s disease, herpes simplex or Grave’s disease.

As this disease is poorly studied, the causes are controversial and experts disagree. However, potential indicators include:

*post-pubescent

*females are more likely than males

*genetic predisposition

*plugged apocrine (sweat) gland or hair follicle

*excessive sweating

*bacterial infection

*sometimes linked with other auto-immune conditions

*androgen dysfunction

*genetic disorders that alter cell structure

*stress can bring on outbreaks

*being overweight makes it worse, however this condition is not caused by obesity and weight loss will improve but not cure it.

*cigarette smoking tends to encourage outbreaks as well

The historical understanding of the disease is that there is a misfunction in either the apocrine glands or hair follicles, possibly triggered by a blocked gland, creating inflammation, pain, and a swollen lesion. More recent studies imply there is an autoimmune component.

HS is not caused by any bacterial infection — any infection is secondary. Most cultures done on HS lesions come back negative for bacteria, so antibiotics should be used only when a bacterial infection has been confirmed by a physician.

Hidradenitis suppurativa is not contagious.

Screening and Diagnosis:
To make a diagnosis, your doctor may ask about your symptoms and medical history, examine your skin, and order blood tests. If pus or drainage is present, your doctor may send a sample of the fluid to a laboratory for testing. This test is known as a culture. Such tests may be necessary to rule out other skin conditions, such as tuberculosis of the skin, a carbuncle or a pilonidal cyst.
General Complications:
Hidradenitis suppurativa often causes complications when the disease is persistent and severe. These complications include:

*Sinus tracts or tunnels that connect and form a network under the skin. The tracts prevent the sores from healing and cause more sores to develop.

*Scars and skin changes. Severe hidradenitis suppurativa may leave thick, raised scars, pitted skin or patches of skin that are darker than normal (hyperpigmentation).

*Restricted movement. The disease may cause limited or painful movement, especially when it affects the armpits or thighs.

*Cellulitis. This potentially serious bacterial infection appears as an area of swollen, red skin that feels hot and tender and that may spread rapidly. Although the initial infection may be superficial, it eventually can affect the tissues underlying your skin or spread to your lymph nodes and bloodstream.

Severe complications:
Left undiscovered, undiagnosed, or untreated, the fistulas from severe stage-3 HS can lead to the development of squamous cell carcinoma in the anus or other affected areas.

Treatments:

There is no cure for hidradenitis suppurativa. But early treatment can help manage the symptoms and prevent new lesions from developing.
Treatments may vary depending upon presentation and severity of the disease. Due to the poorly-studied nature of this disease, the effectiveness of the drugs and therapies listed below is not yet clear, and patients should discuss all options with their doctor or dermatologist. Nearly a quarter of patients state that nothing relieves their symptoms. A list of treatments that are possible treatments for some patients is as follows.

*lifestyle

*changes in diet.

*warm compresses, baths (to induce drainage)
medication
*ntralesional corticosteroid injections (to reduce inflammation)

*oral antibiotics (to treat inflammation and bacterial infection)

*isotretinoin (Accutane), a prescription-only oral acne treatment (benefits for HS are very controversial, but it is generally considered to be ineffective)

*anti-androgen therapy

*sub-cutaneous injection or IV infusion of anti-inflammatory (anti-TNF-alpha) drugs such as infliximab (Remicade), etanercept (Enbrel), and adalimumab. This use of the drugs is not currently Food and Drug Administration (FDA) approved and is

*somewhat controversial, and therefore may not be covered by insurance.
Acitretin

*Zinc gluconate taken orally has been shown to induce remission
surgery (But Obesity, incomplete removal and ongoing skin infections can increase the chances that hidradenitis suppurativa returns, even after surgical treatment.)

*incision and drainage or lancing

*wide local excision (with or without skin grafting), or laser surgery

*radiotherapy

Self-care:
The following suggestions may help relieve discomfort, speed healing and prevent the infection from spreading:

*Apply a warm washcloth or compress to help reduce swelling.

*Gently wash the affected areas with antibacterial soap. After washing, apply an over-the-counter antibiotic.

*Wear loosefitting clothes and underwear to prevent skin irritation.

*Avoid shaving the affected areas to prevent skin irritation.

*Don’t smoke. Smoking can worsen symptoms and trigger new outbreaks.

Excess weight increases the number of areas where skin rubs together — for example, between skin folds — causing friction, increased perspiration and bacterial growth. Though weight loss won’t cure the disease, it may improve symptoms.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Hidradenitis_suppurativa
http://www.mayoclinic.com/health/hidradenitis-suppurativa/DS00818/DSECTION

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