Hidradenitis
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Hidradenitis is any disease in which the
histologic Histology, also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vis ...
abnormality is primarily an inflammatory infiltrate around the eccrine glands.James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. . This group includes neutrophilic eccrine hidradenitis and
recurrent palmoplantar hidradenitis Recurrent palmoplantar hidradenitis is primarily a disorder of healthy children and young adults, characterized by lesions that are primarily painful, subcutaneous nodules on the plantar surface, resembling erythema nodosum Erythema nodosum (EN) ...
. It can also be defined more generally as an inflammation of
sweat gland Sweat glands, also known as sudoriferous or sudoriparous glands, , are small tubular structures of the skin that produce sweat. Sweat glands are a type of exocrine gland, which are glands that produce and secrete substances onto an epithelial sur ...
s.
Hidradenitis suppurativa Hidradenitis suppurativa (HS), sometimes known as acne inversa or Verneuil's disease, is a long-term dermatological condition characterized by the occurrence of inflamed and swollen lumps. These are typically painful and break open, releasing ...
is a chronic cutaneous condition originally thought to be primarily characterized by suppurative inflammation of the apocrine sweat glands.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. . Recent evidence supports that the primary event is follicular hyperkeratosis and obstruction, but the term hidradenitis supperativa has continued to be used in major medical journals.


Symptoms

Hidradenitis suppurativa is a chronic inflammatory skin condition, considered a member of the acne family of disorders. It is sometimes called acne inversa. The first signs of HS are small bumps on the skin that resemble pimples, cysts, boils, or folliculitis. As the disease progresses and abscesses reoccur, they become larger and more painful; eventually tunnels of scar tissue connect the lesions. These lesions may open up if they become too enlarged and drain bloodstained pus.


Risk factor

One risk factor is age; HS usually starts after puberty, usually in the teens and twenties. The condition is much more common in women than in men but is usually more serious and debilitating in men. Other associated conditions include obesity, diabetes, metabolic syndrome, arthritis, acne, and other inflammatory disorders. Early diagnosis of this disease is very important to decrease the number of flares, pain, and discomfort.>Revuz, J. E., Canoui-Poitrine, F., Wolkenstein, P., Viallette, C., Gabison, G., Pouget, F., ... & Grob, J. J. (2008). Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. Journal of the American Academy of Dermatology, 59(4), 596-601.


Treatment

The Mayo Clinic suggests the following: antibiotics (generally the lowest side effect profile compared to other treatments);
corticosteroids Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involve ...
(e.g., prednisone); but corticosteroids have many side effects, including " moon face" for the duration of the medication's trial usage, as well as unwanted hair growth for females and/or
osteoporosis Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone ...
with long-term use. Tumor necrosis factor (TNF)-alpha inhibitors like infliximab (Remicade) and adalimumab (Humira) have shown promise for some, but they should probably be considered a third-line treatment, as treatment is associated with increased risk of infection,
heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...
and certain cancers. Surgery is also available for those overwhelmed by the condition, but it will not cure the condition, just relieve the skin-related issues for a while. The disease is pernicious and is almost always guaranteed to return, if not in the same spot where the surgery was performed.Mayo Clinic: Hidradenitis suppurativa support
/ref> Some products for adult acne may help relieve some symptoms for people with hidradenitis, although there is no guarantee it will work in all or even most individuals. Birth control medication may relieve some symptoms for women; there is a hormonal treatment for men as well, but that has not been proven to be safe or effective as of yet.Birth Control Pills for Certain Female Skin-Related Issues
/ref> Alternative treatments not approved by the FDA include
alpha hydroxy acids α-Hydroxy acids, or alpha hydroxy acids (AHAs), are a class of chemical compounds that consist of a carboxylic acid with a hydroxyl group substituent on the adjacent (alpha) carbon. Prominent examples are glycolic acid, lactic acid, mandelic acid ...
(naturally available in small amounts in citrus fruits),
Azelaic acid Azelaic acid (AzA) is an organic compound with the formula HOOC(CH2)7 COOH. This saturated dicarboxylic acid exists as a white powder. It is found in wheat, rye, and barley. It is a precursor to diverse industrial products including polymers an ...
, and
zinc Zinc is a chemical element with the symbol Zn and atomic number 30. Zinc is a slightly brittle metal at room temperature and has a shiny-greyish appearance when oxidation is removed. It is the first element in group 12 (IIB) of the periodi ...
. It is not thought that they are as effective as standard medical treatment, but they tend to have less side effects. Some suggest tea tree oil and a specific strain of
brewer's yeast Yeasts are eukaryotic, single-celled microorganisms classified as members of the fungus kingdom. The first yeast originated hundreds of millions of years ago, and at least 1,500 species are currently recognized. They are estimated to constitu ...
, called CBS 5926. However, tea tree oil can cause contact dermatitis for some as well as breast development in teenage boys and should not be used if one has
rosacea Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often, the nose, cheeks, forehead, and chin are most involved. A red, enlarge ...
due to the potentiality of worsening the symptoms of that skin condition. CBS 5962 can also cause migraines and intestinal issues for some.Are there any effective natural skin treatment options?
/ref>


References


External links

{{Disorders of skin appendages Conditions of the skin appendages