What is hidradenitis suppurativa?
Hidradenitis suppurativa (HS, also acne inversa, ectopic acne (acne ectopica) or disease called Verneuil) is a skin condition characterized by always in the same place recurrent episodes. This mainly occurs in the groin, genitals, buttock crease and armpits, and under the breasts and tummy tucks. The disease is difficult to treat and is very stressful for patients.
Genesis
Hidradenitis suppurativa is caused by inflammation of hair follicles. The infections are spreading through the skin and are abscess cavities and course. These corridors will always rekindle and scarring gradually. Why do some people get this kind of inflammation and other not, is unknown. A large proportion of the patients (but not all) smoked at the time of the onset of the symptoms, so that might have an impact. The effect of smoking cessation on the course of the symptoms is not known in the medical literature. Also, genetic predisposition plays a role.
Hidradenitis suppurativa treatment
- The effect of shaving or just stop shaving is usually nil.
- Often smoking cessation is recommended. The effect is never measured.
- Restrictive, abrasive clothing is often tedious and can sometimes provoke inflammation.
- Local treatment with cream containing Resorcinol 5%, 10%, 15% can counteract the formation of new infections, as well as the disinfection repeated daily for several weeks of the affected skin with betadine-iodine.
- Prolonged use of antibiotics makes the disease (temporarily) quieter. Often this means as tetracycline, doxycycline or minocycline used to.
- Active infections can be treated at an early stage with injection of triamcinolone.
- Excision and drainage of abscesses can contribute. However, there is a high risk of relapse. One effective method is "deroofing '(large) open up all the subcutaneous cavities. The wound must close automatically grow; this is relatively fast and with reduced scarring. Simple incision and drainage is applied with caution: the more scars in the area arise, the more chance of recurrence.
- Most recently added to the list of methods of treatment of chronic progressive suppurative hidradenitis, TNF-alpha blocker therapy. This is a group of drugs that target the disease more at the source, and thus also has a much better effect. Results are often visible within a few weeks. Deroofing remains, however, a necessity in the short term. In the long term this with good efficacy of the therapy is no longer needed.
- Skin transplants: Full affected area get verwijderd.Dit get covered with skin grafts. Sometimes it happens that the affected area is too close to the anus and then for this operation a temporary stoma is necessary. It is rare that hidradenitis comes back into the skin graft.
Naming
Hidradenitis means sweat gland inflammation; Hidros: sweat, adeno: gland, itis: inflammation. Suppurativa: purulent. The normal (eccrine) sweat glands, however, have no role in the disease process. The condition is particularly in those parts of the skin in front of where the specific sweat glands are involved in puberty and thereafter are responsible for the body odor, the apocrine sweat gland Many experts therefore prefer to call the condition acne or acne inversa ectopica. Hidradenitis suppurativa remains by far the most used denomination.