In early stages hidradenitis suppurativa may start as a solitary abscess resembling a carbuncle, lymphadenitis or an infected epidermoid cyst. Clinicians should suspect hidradenitis suppurativa in any patient that presents with abscess-like swelling in apocrine gland-bearing skin.
Recurrent abscesses, and single or multiple widely separated lesions with sinus tract formation and cicatrization are characteristic of the second stage.
In advanced stages, bands of scar tissue and bridging fibrosis develop. Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses are common.
Complications and treatment
Complications include secondary infection, restricted mobility from extensive scarring and fistula formation, and occasionally squamous-cell carcinoma. Long-term antibiotics, weight-loss, antiandrogens and surgery are therapeutic options.
Hidradenitis suppurativa is a chronic, inflammatory, scarring disease that affects patches of skin where the apocrine sweat glands are located, such as the axilla, groin, perianal and inframammary areas.
Considered a severe form of acne, the disease is characterized by multiple abscesses fibrosis and sinus tract formation, and often progresses despite treatment. Follicular occlusion is prominent in all patients with hidradenitis suppurativa, and some have suggested the disease is primarily follicular with secondary or incidental apocrine gland inflammation.
Hidradenitis suppurative occurs in patients between puberty and age 40 years and is most common in adults aged 20 to 30 years. Although it affects both sexes, it is more prevalent among women. View the slideshow below and learn more about hidradenitis suppurative.