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)
How to Say It: HID-ra-den-EYE-tis SUP-you-rah-TEE-vah
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.
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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:
- Having family members who have HS
- Smoking—present or past
- Obesity
- Diabetes
- Metabolic syndrome
- High cholesterol
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.
Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD Last Updated: 5/19/2021