Hidradenitis suppurativa aka Acne inversa

Have you ever heard of this chronic condition called Hidradenitis suppurativa (HS)also called Acne inversa?

A condition that mostly affects otherwise HEALTHY post pubertal individuals and usually involves areas where we have sweat glands called apocrine glands.

I have made a post before on the type of sweat glands we have and recall that apocrine glands are those that do not become active until puberty (Found in areas such as the armpits and the groin). The major problem in HS is occlusion of the follicles which leads to some recurrent ‘boil like’ lesions in areas like the armpit and groin that may progress to form sinuses and abscesses (that keep discharging) and scars in those areas. In the early stages, you see more of those boils which keep discharging. It may be associated with arthritis in some individuals.

Can have a significant impact on the quality of life of affected individuals. The cause is not exactly known. HS should be considered as a diagnosis when a healthy individual keeps having recurrent having ‘boils’ & abscesses with or without scars in a symmetrical way (i.e involving two areas at the same time like the two armpits). It may be more common in females. Factors associated with it include cigarette smoking and obesity.

Management involves improvement of local hygiene, weight loss, cessation of cigarette smoking, wearing of loose clothing amongst others.

Zinc shampoo to wash the areas may be beneficial.

Some antibiotics and other drugs have been found to be useful. LASER and surgery may also be an option especially when scarring has occured.

It tends to run a remitting and relapsing course and it is important to start management early and counsel the patients adequately.

Any questions in the comments section?