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Hidradenitis suppurativa

Hidradenitis suppurativa or HS is a poorly studied skin disease that affects the sweat (apocrine) glands primarily located in the underarms, groin, and under the breasts in women. The disease is chronic and can progress to severely painful and debilitating. It is considered a rare disease, with an incidence rate of 1 in 1,000 to 1 in 300 people, but because it is difficult to diagnose and can easily be mistaken for acne, many sufferers go undiagnosed and improperly treated.

Stages

HS presents itself in three stages:

  1. A few minor sites with rare inflammation; may be mistaken for blackheads.
  2. Frequent inflammations restrict movement and require minor surgery.
  3. Inflammation of sites to the size of golf balls, or sometimes baseballs; scarring develops, including subcutaneous tracts of infection. Patients in this stage may be unable to hold down a job.

Causes

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
  • ingrown hairs
  • plugged sweat gland
  • excessive sweating
  • use of anti-perspirant or deodorant
  • bacterial infection
  • linked to some immunodeficiency conditions
  • genetic predisposition

Treatment

Treatment may vary depending upon the stage of the disease.

  1. Will resolve in 10-30 days on its own. Otherwise, warm compresses, oral antibiotics (treat inflammation and any bacterial component)
  2. Oral antibiotics, incision and drainage, oral contraceptives
  3. Wide local excision (with or without skin grafting), laser surgery, radiotherapy
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