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by EBSCO Medical Review Board

Hidradenitis Suppurativa

(Acne Conglobata; Acne Inversa [AI]; Apocrine Acne; Apocrinitis; Fox-Den Disease; HS; Hydradenitis Suppurativa; Pyodermia Significa Fistulans; Velpeau's Disease; Verneuil's Disease)

Definition

Hidradenitis suppurativa (HS) is a disease that results in deep and painful lumps under the skin, often in the armpits or groin. They may also be found under the breasts and between the buttocks.
Skin, Hair, Hair Follicle
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Causes

HS happens when hair follicles become blocked. It is not known why this happens.
Genes, the environment, and problems with the immune system may also play a role.

Risk Factors

HS is more common in women. Other things that may raise the risk are:

Symptoms

The problem often starts when a person is in their 20s. Problems may be:
  • Burning, itching, or painful lumps in the armpits, groin, under the breasts, or between the buttocks
  • Pus leaking from breaks in the lumps
  • Scarring

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on your skin. This is often enough to make the diagnosis.

Treatment

The goal of care is to control outbreaks. Options are:
  • Lifestyle changes, such as maintaining a healthy weight, not smoking, and wearing loose clothing
  • Medicines, such as:
    • Antibiotics
    • Corticosteroids
    • Biologic agents
    • Retinoids
    • Hormonal therapy
People with severe symptoms may need a surgery or procedure to remove the painful lumps.

Prevention

There are no known guidelines to prevent this problem.

RESOURCES

American Academy of Dermatology
https://www.aad.org
Hidradenitis Suppurativa Foundation
http://www.hs-foundation.org

CANADIAN RESOURCES

Canadian Dermatology Association
https://www.dermatology.ca
Health Canada
https://www.canada.ca

References

Hidradenitis suppurativa. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hidradenitis-suppurativa. Accessed October 23, 2020.
Hidradenitis suppurativa. NORD—National Organization of Rare Diseases website. Available at: https://rarediseases.org/rare-diseases/hidradenitis-suppurativa. Accessed October 23, 2020.
Zouboulis CC, Desai N, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015 Apr;29(4):619-644.
11/30/2015 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/condition/hidradenitis-suppurativa: Tzellos T, Zouboulis CC, et al. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol 2015;173(5):1142-1155.

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