Hidradenitis suppurativa (HS)
Overview
Hidradenitis suppurativa (HS) is a painful, long-term skin condition that causesskin abscessesand scarring on the skin.
Symptoms
The symptoms of hidradenitis suppurativa range from mild to severe. It causes a mixture ofboil-like lumps, blackheads, cysts, scarring and channels in the skin that leak pus. The condition tends to start with blackheads, spots filled with pus and firm pea-sized lumps that develop in one place. The lumps will either disappear or rupture and leak pus after a few hours or days. New lumps will then often develop in an area nearby. If these are not controlled with medicine, larger lumps may develop and spread. Narrow channels called sinus tracts also form under the skin that break out on the surface and leak pus. Hidradenitis suppurativa can be very painful. The lumps develop on the skin in the following areas: around the groin and genitalsin the armpitson the bottom and around the anusbelow the breasts The lumps may also appear on the nape of the neck, waistband and inner thighs. Some of the lumps may become infected with bacteria, causing a secondary infection that will need to be treated withantibiotics. Many people with hidradenitis suppurativa also develop apilonidal sinus, which is a small hole or "tunnel" in the skin at the top of the buttocks, where they divide (the cleft).
Causes
The exact cause of hidradenitis suppurativa is unknown, but the lumps develop as a result of blocked hair follicles. Smokingandobesityare both strongly associated with hidradenitis suppurativa, and if you're obese and/or smoke it will make your symptoms worse. Hidradenitis suppurativa usually starts around puberty, but it can occur at any age after puberty. This may suggest that sex hormones play a part. Many people with the condition also haveacneandexcessive hair growth (hirsutism). In rare cases, hidradenitis suppurativa may be linked toCrohn's disease, particularly if it develops around the groin area and the skin near the anus. Crohn's disease is a long-term condition that causes the lining of the digestive system to become inflamed. Hidradenitis suppurativa runs in families in about 1 in 3 cases. It's not infectious and isn't linked to poor hygiene.
Treatment
In severe cases of hidradenitis suppurativa, treatments that suppress the immune system, such asadalimumabor infliximab, can be useful. However, there are risks associated with suppressing the immune system, so they are usually only prescribed by a dermatologist if other treatments do not work. Immunosuppressive treatments such as infliximab and adalimumab are given by injection or infusion at regular intervals, either at home or in hospital.