- Acne inversa
Your QuestionMy friend has hidradenitis suppurativa. Can you please help me find more information?
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Hidradenitis suppurativa is characterized by:
- Small pitted areas of skin containing blackheads;
- Red, tender bumps or lesions that enlarge, break open and drain pus that may have an unpleasant odor;
- Painful hard lumps that develop under the skin and may enlarge and/or persist for years; and
- Leaking bumps or sores that heal very slowly and can lead to scarring and tunnels under the skin (called sinus tracts).
Hidradenitis suppurativa commonly occurs in areas near hair follicles where there are many oil and sweat glands; places like the armpit, groin and anal area. It can also occur in areas where skin rubs together, including the inner thighs, under the breasts, and between the buttocks.
This condition most often presents after puberty and can persist for years, worsening over time. Three stages of disease have been described which progress from single or localized abscesses accompanied by itching or discomfort, to recurrent abscesses that occur in multiple locations, to widespread severe disease that can restrict movement, obstruct lymph drainage and lead to social isolation.
A family history of HS is reported in approximately 1/3 patients. Researcher suspect that HS is inherited or passed down in an autosomal dominant manner. This means that if an individual inherits HS, they have a 50% chance to pass it to the next generation. These risks may be lower, as there are likely other influences that impact one's likelihood of developing HS. Researchers are currently trying to identify which genes may be implicated in HS. Some cases have been found to result from mutations in the NCSTN, PSEN1, or PSENEN gene. More studies are needed to determine whether other genes might be involved.
In advanced cases, affected individuals may undergo surgery (e.g., laser therapy or photodynamic therapy), but recurrences of HS are not uncommon. Systemic therapies are still being researched. The goals of these therapies are to heal existing lesions and prevent the development of new lesions in the areas potentially affected by the disease.
- Lee R. Hidradenitis Suppurativa. National Organization of Rare Disorders Web site. 2012; http://rarediseases.org/rare-diseases/hidradenitis-suppurativa/. Accessed 3/6/2015.
- Hidradenitis suppurativa. Genetics Home Reference. December 2013; http://ghr.nlm.nih.gov/condition/hidradenitis-suppurativa. Accessed 3/6/2015.
- Jovanovic M. Hidradenitis Suppurativa. Medscape Reference. January 5, 2015; http://emedicine.medscape.com/article/1073117-overview#showall. Accessed 3/6/2015.
- Hidradenitis suppurativa: Symptoms. Mayo Clinic. April 9, 2013; http://www.mayoclinic.org/diseases-conditions/hidradenitis-suppurativa/basics/symptoms/con-20027334. Accessed 10/6/2015.
- Kidradenitis suppurativa. The Hidradenitis Suppurativa Trust. November 10, 2012; http://www.hstrust.org/info.html. Accessed 10/6/2015.
- Ingram JR. The Genetics of Hidradenitis Suppurativa. Dermatol Clin. January 2016; 34(1):23-28. http://www.ncbi.nlm.nih.gov/pubmed/26617354.
- Hughes R, Kelly G, Sweeny C, Lally A, Kirby B. The Medical and Laser Management of Hidradenitis Suppurativa. Am J Clin Dermatol. February 24, 2015; http://www.ncbi.nlm.nih.gov/pubmed/25708371. Accessed 3/6/2015.