Hidradenitis suppurativa: a review

Abstract

Hidradenitis suppurativa is a recurrent disease involving apocrine-bearing skin with a predilection for intertriginous areas, including genital skin. It has a highly variable clinical course. Mild cases may present as recurrent isolated nodules, while severe instances of the disease with chronic inflammation may lead to scarring, functional impairment, and rarely, squamous cell carcinoma. While genetic factors, patient characteristics, hormones and infection play a role in disease expression, a comprehensive understanding of the pathogenesis remains to be elicited. Additionally, effective treatment is largely unknown. While the mainstay of therapy had been surgery, and topical or systemic antimicrobial agents, other therapeutic modalities such as retinoids, hormonal therapy and immunosuppresive medications may also hold some promise.

Severe Hidradenitis Suppurativa Treated With Adalimumab

“…1 The disease typically presents in postpubertal individuals with symptoms of discomfort and/or pruritus associated with a tender papule or deeper-seeded nodule. 2 The nodule may resolve but often can recur in groups, which can lead to abscess formation. The lesions often heal with fibrosis and dermal contractures, which can result in scarring.…”

“…The lesions often heal with fibrosis and dermal contractures, which can result in scarring. 2 Sinus tracts are common in more advanced disease. The disease involves aprocrine skin with a predilection for the intertriginous areas, often involving the axillae, groin, perineum, and inframammary and retroauricular regions.…”

Reconstructive options in severe cases of Hidradenitis suppurativa

“…However, there are some general principles of surgical approaches. Firstly, incision and drainage should be avoided because it is of limited value [34][35]. As the treatment of choice, surgical removal of the involved tissue is strongly advised [3,[36][37].…”

Laser and light-based treatments of hidradenitis suppurativa

“…It is not a rare disease, with a global prevalence reported between 1 and 4% [1]. It occurs more frequently in females than males with a 4:1 ratio [2]. The axilla is the most commonly affected site and involvement of other sites depends on gender.…”