Can you live a normal life with hidradenitis?

What happens in hidradenitis suppurativa ?

• Hidradenitis suppurativa is a chronic inammatory skin disease characterized by recurrent and scarring lesions limited to the axillae, submammary or perigenital areas. 
• Most patients are treated by physicians as simple infections with antibiotics combined with incision or/and drainage. 

• Because these treatments are rarely, if ever, effective, patients frequently face significant delays in both diagnosis and treatment. 

Who is at risk for hidradenitis suppurativa?

• HS typically manifests after puberty implying that either female factors or the absence of male factors play a role in the pathogenesis of HS. 

Is hidradenitis life threatening ?

• HS is a severe disease. 
• It has a huge psychological impact on patients. 
• It causes difficult signs such as smell , scars, itching, and pain. 
• It also affects the genitalial skin, and alters the intimate relationships  furthermore, several studies have found an increased prevalence of depression among patients with HS. 

What is the best treatment for hidradenitis suppurativa ?

All patients should recieive adjuvant, medical, and surgical treatments combined and adapted to the severity of the disease. 

Adjuvant treatment

1. Analgesics : alleviate pain
2. Antibiotic : treatment of superinfections 
3. Weight loss
4. Tobacco cessation

Medical treatment

1. Topical clindamycin 0.1 % : applied to lesions for up to 10 weeks, 
2. Tetracycline 500 mg : for up to 12 weeks
3. Combination of clindamycin 300 mg b.i.d. and rifampicin 300 mg b.i.d. for 10 weeks
4. Iniximab (5 mg/kg) 
5. Adalimumab 160 mg the first week,  80 mg the second week, and then 40 mg every week. 

Surgery for hidradenitis suppurativa

• Surgical treatment from minor surgery to complete excisions of all diseased skin.
• If inamed nodules are incised, it is usually unsuccessful and has a 100% recurrence rate, and may only add scarring to an already scarring disease.