Hidradenitis suppurativa

Hidradenitis suppurativa is a chronic idiopathic, usually bacterially sterile, inflammatory disease of the apocrine glands, in which pathogenic bacteria, such as staphylococcal aureus, often occur as a secondary factor. The condition is chronic, involving predominantly the axilla and groin areas. Large abscesses develop, which heal with chronic draining sinuses and scar formation.
Patients with hidradenitis suppurativa appear to be more likely to have the severely cystic form of acne vulgaris, acne conglobata.

Treatment:

• Antibiotics both topical and oral can be used
• Clindamycin topically and tetracycline may be of value
• Surgical excision of the affected area
• Intra-lesional steroids
• Case reports show that retinoids, both isotretinoin and acutretin, may be helpful in some, although high doses need to be used
• Immunosuppression with cyclosporine has also been documented

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