Hidradenitis

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Hidradenitis
Classification and external resources
MeSH D016575

Hidradenitis is any disease in which the histologic abnormality is primarily an inflammatory infiltrate around the eccrine glands.[1]:780 This group includes neutrophilic eccrine hidradenitis and recurrent palmoplantar hidradenitis.[1]:780

It can also be defined more generally as an inflammation of sweat glands.[2]

Hidradenitis suppurativa is a chronic cutaneous condition originally thought to be primarily characterized by suppurative inflammation of the apocrine sweat glands.[3]:710 However, recent evidence supports that the primary event is follicular hyperkeratosis and obstruction.[4]

Symptoms and Risk Factors[edit]

Hidradenitis suppurativa is a chronic inflammatory skin condition, considered a member of the acne family of disorders. It is sometimes called acne inversa. The first signs of HS are small bumps on the skin that resemble pimples, cysts, boils, or folliculitis. As the disease progresses and abscesses reoccur, they become larger and more painful; eventually tunnels of scar tissue connect the lesions. These lesions may open up if they become too enlarged and drain bloodstained pus. One risk factor is age; HS usually first appears during the 20s and early 30s. The condition is much more common in women than in men but is usually more serious and debilitating in men. Other associated conditions include obesity, diabetes, metabolic syndrome, arthritis, acne, and other inflammatory disorders. Early diagnosis of this disease is very important to decrease the number of flares, pain, and discomfort. [5]

Treatment of symptoms[edit]

The Mayo Clinic suggests the following: antibiotics (generally the lowest side effect profile compared to other treatments); corticosteroids (e.g., prednisone); but corticosteroids have many side effects, including "moon face" for the duration of the medication's trial usage, as well as unwanted hair growth for females and/or osteoporosis with long-term use. Tumor necrosis factor (TNF)-alpha inhibitors like infliximab (Remicade) and adalimumab (Humira) have shown promise for some, but they should probably be considered a third-line treatment, as treatment is associated with increased risk of infection, heart failure and certain cancers. Surgery is also available for those overwhelmed by the condition, but it will not cure the condition, just relieve the skin-related issues for a while. The disease is pernicious and is almost always guaranteed to return, if not in the same spot where the surgery was performed.[6]

Some products for adult acne may help relieve some symptoms for hidradenitis sufferers, although there is no guarantee it will work in all or even most individuals. Birth control Medication may relieve some symptoms for women; there is a hormonal treatment for men as well but that has not proven to be safe or effective as of yet.[7]

Alternative treatments include alpha hydroxy acids (naturally available in small amounts in citrus fruits), Azelaic acid, and zinc. It is not thought that they are as effective as standard medical treatment but they tend to have less side effects. Some suggest tea tree oil and a specific strain of brewer's yeast, called CBS 5926. However, the former can cause contact dermatitis for some as well as breast development in teenage boys and should not be used if one suffers from rosacea as well due to it making the symptoms of that strand of acne worse; the latter (CBS 5962) can cause migraines and intestinal issues for some. None of these have been formally tested by the FDA so beware the risk you take when you forgo traditional Western medicine for herbal supplements.[8]

References[edit]

  1. ^ a b James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. ^ "hidradenitis" at Dorland's Medical Dictionary
  3. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  4. ^ Sellheyer K, Krahl D (July 2005). ""Hidradenitis suppurativa" is acne inversa! An appeal to (finally) abandon a misnomer". Int. J. Dermatol. 44 (7): 535–40. PMID 15985019. doi:10.1111/j.1365-4632.2004.02536.x. 
  5. ^ Revuz, J. E., Canoui-Poitrine, F., Wolkenstein, P., Viallette, C., Gabison, G., Pouget, F., ... & Grob, J. J. (2008). Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. Journal of the American Academy of Dermatology, 59(4), 596-601.
  6. ^ Mayo Clinic: Hidradenitis suppurativa support
  7. ^ Birth Control Pills for Certain Female Skin-Related Issues