Hidradenitis suppurativa

It is a chronic inflammatory skin disease that affects apocrine gland-bearing skin in the axillae, groin, and under the breasts.

It is characterized by recurrent boil-like nodules and abscesses that can have a purulent discharge,

Sinus formation and scarring sometimes. sinuses, and scarring.

It has a significant psychological impact

Risk factors

Family members with hidradenitis suppurativa

Obesity /metabolic syndrome

Cigarette smoking

Inflammatory bowel disease (Crohn disease)

African ethnicity

Diabetes Mellitus

Clinical features

Double-headed comedones

Painful firm papules and nodules

Pseudocysts, and abscesses

Hypertrophic and atrophic scars

Draining sinuses

Diagnosis

Clinical

Management

General measures

Weight loss

Smoking cessation

Loose-fitting clothing

Absorbent dressings

Analgesics

Pharmacological

Apply hydrogen peroxide solution or medical grade honey to reduce malodor

Topical clindamycin, with benzoyl peroxide to reduce bacterial resistance

A 1-week course of flucloxacillin

Anti-androgen – Oral contraceptive pills

Intralesional corticosteroids

Methotrexate- in severe case

Surgical

Incision and drainage

Radical excision surgery

Complications

Pyogenic granuloma

Lymphodema

Depression