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Hydradenitus Supperativa (HS)

Q: What is Hydradenitus Supperativa?

Dr. Donnica:
Hidradenitus Supperativa (HS) has been called by many other names including "acne inversa," but it is not well known among patients or physicians. Its name describes its appearance: oozing, inflamed sweat glands. This sometimes debilitating autoimmune disorder appears as severe, recurrent boils. Unfortunately, it can often take up to 10 years to diagnose this condition correctly because of limited awareness by healthcare professionals and extreme embarrassment from the nearly one million Americans who suffer from it. Of even greater concern is that its cause is unknown, there is no known consistently effective treatment, and no major research effort under way to aggressively seek a cure.

HS is a non-contagious, recurrent skin disease usually found in areas of the body where there is skin-to-skin contact (such as armpits, groin, thighs, and under breasts) and around hair follicles where apocrine sweat glands are located. Characteristically, it progresses from boils or abscesses to hard lumps and painful, rounded deep-seated inflamed lesions with subsequent scarring and chronic seepage (aka suppuration). These hard lumps occur under the skin and may grow as large as baseballs. In many cases, they are very painful and may persist for years with or without recurrent inflammation. Inflamed lumps may lead to extensive drainage, which may cause the development of sinus tracts under the skin. These may heal slowly or not at all, which may lead to further inflammation and lumps. Bacterial infections are possible at these sites. Draining the lumps may provide some pain relief, but the lumps and tracts often recur.

Because HS may be extremely painful and the drainage may have a foul odor, sufferers often limit their activities including work or even going out in public. As a result, HS sufferers often suffer from depression as well.

For unknown reasons, HS is often associated with several other conditions including polycystic ovarian syndrome (PCOS), insulin resistance, diabetes, Crohns disease, anemia, hyperhidrosis, acne, and pilonidal cysts.

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Created: 7/5/2004  -  Donnica Moore, M.D.

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