Hidradenitis Suppurativa

Abstract

Hidradenitis suppurativa is a chronic, inflammatory, follicular disease that usually presents at or after puberty. Painful, deep‐seated inflamed skin lesions occur in apocrine gland‐bearing areas, most commonly the axillary, inguinal and ano‐genital regions. The skin lesions may discharge blood‐stained pus and leave scarring, including skin tunnel formation. Prevalence is estimated at 1% and, in Europe, young adult women are particularly affected. There is a link with smoking, obesity, depression and cardiovascular disease. Baseline disease severity is typically measured by Hurley staging and response to treatment by pain numerical rating scales, quality of life, a lesion count and global assessment. Medical treatment includes antibiotics, anti‐androgens, and antitumour necrosis factor  therapies, integrated with surgical options such as deroofing and wide excision.