Hidradenitis Suppurativa (HS): A Rare Adult Skin Disease

Hidradenitis suppurative (HS), a rarely encountered skin disease is more than just a boil. The course of the clinical presentation varies from that of pitted blackheads to painful pea-sized lumps and bumps connected by tunnels underneath the skin. These bumps are at risk of becoming secondarily infected, transforming into pockets under the skin. Additionally, these pockets might break open producing a bad odor. For enhanced patient care, you may volunteer in Dermatological Clinical Trials for hidradaenitis suppurative (HS) or other skin conditions.

The condition, although dermatological in origin, takes a toll on the body both emotionally and physically. Combined medical and surgical treatments are the cornerstones of comprehensive management depending on the disease’s severity.

To learn more about the clinical presentation of HS, lifestyle modifications, and conventional treatment options continue reading the blog.

What is Hidradenitis Suppurativa (HS)?

Put simply, hidradenitis suppurativa is a chronic skin condition affecting those areas of the body where sweat glands are present. The course of the treatment regimen varies from taking antibiotics alongside steroids to help relieve inflammation, with surgery as a last resort. 

If you are someone experiencing either of the following symptoms, that are holding you back, refer to your doctor for a diagnosis:

• Is painful
• Limits your movement, making it difficult to move
• Doesn’t improve in a period of a few weeks
• Relapse within weeks of treatment
• Widely distributed
• Frequent flareups

Acne inversa is an alternate name for hidradenitis suppurative (HS) because of the characteristic feature such as the formation of painful bumps beneath the skin in the hair roots and near some of your sweat glands. Sinuses form open channels for infections, leading to secondarily infected bumps forming pockets underneath the skin, producing a foul odor.

As of yet, the exact cause of hidradenitis suppurative (HS)  is not understood but in most cases, these lumps develop as a result of blocked hair follicles. Other influential factors are genes, hormones, and environmental risks.

Incidence of the Disease:

You might be doing fine in your life but suddenly start experiencing symptoms of hidradenitis suppurative (HS) maybe because you paid a visit or got into close contact with any of your relatives dealing with hidradenitis suppurative (HS). This makes you aware of the fact that HS is a contagious disease. Statistically, about 1 in 3 cases report hidradenitis suppurativa (HS) as a family history.

Hidradenitis suppurativa is more prevalent in women around their puberty, although can occur at any age. The onset of the first symptoms usually appears in the teens and early 20s.

The exact root cause of hidradenitis suppurativa is not established, but in most cases, it is strongly linked to poor hygiene. According to some other studies, a correlation exists between hidradenitis suppurativa (HS) and sex hormones. This is proven when other cases rarely report before puberty and after menopause, suggesting the influence of sex hormones on the incidence of HS with age.

Additionally, women who smoke and are obese are twice more likely to get hidradenitis suppurativa. However, you might be a smoker with skin manifestations, not necessarily producing effects linked to the organ system being affected. It is important to take notice of hidradenitis suppurativa (HS) and many other health deteriorating conditions that are prone to worsening symptoms because of smoking and a bad lifestyle. 

Clinical Presentation:

Hidradenitis suppurativa (HS) is identified as a painful, long-lasting skin condition with abscesses and scarring as a predominant hallmark of the disease. The persistence of symptoms can be infuriating but comprehensive management options exist to subside pain and inflammation.

Pea-sized fleshy lumps with draining sinus tracts are some of the first signs of the disease. These painful bumps tend to affect both sides of the body, with a widespread distributive pattern or confined to particular regions. You could have repeated outbreaks lasting for a few days or months in the exact location.

The commonly affected sites of the body where skin folds elicit blockage are:

• Around the groin and genitals
• Armpits
• Surrounding the anal region
• Below the breasts
• Between buttocks
• Between thighs (inner side of thighs)
• In folds of stomach
• Nape of neck
• Behind ears

The onset of symptoms of hidradenitis suppurativa (HS) varies in intensity, ranging from mild to moderate to severe in a few cases. On the other hand, the array of clinical presentations is a mixture of boil-like lumps, blackheads, cysts, scarring, and sinus tracts (pilonidal sinus) in the skin that leak pus.

Diagnostic Criteria:

To determine the right diagnosis, your doctor will evaluate your condition by asking some relatable questions like:

• How often do you experience the onset of lumps and bumps?
• What is the commonly affected site in your body?
• How long ago did your symptoms start showing?
• Is it painful?
• Have you had any close relatives suffering from this problem?

Obtaining answers to all these questions is essential for excluding differential diagnoses, which might be the reason for the onset of these painful lumps.

Depending on its severity, hidradenitis suppurative (HS) is categorized into 3 stages (also known as Hurley stages):

• Stage I: Single or multiple confined bumps with no sinus tracts.
• Stage II: Multiple bumps with few draining sinus tracts and scarring.
• Stage III: Widespread distribution of multiple bumps, with multiple sinus tracts and scarring.

Treatment for Hidradenitis Suppurativa (HS):

There is no such thing as an “ideal treatment” available in the market for prompt recovery from hidradenitis suppurativa (HS). You might have to try multiple treatments to find the one that works best for you. Moreover; whatever suitable treatment your doctor decides for you depends on the severity of the stage.

Available treatment options to relieve pain, inflammation, and swelling are:

• A warm compress for 10 minutes works fine for mild cases.
• NSAIDS: OTC medications help relieve pain and inflammation.
• Antibiotics: Indicated to combat secondary infections.
• Corticosteroid injections: Directly administered into the bumps to relieve pain, inflammation, and swelling.
• Oral retinoids: For severe cases
• Biologics: Administered via I.V. for strengthening your body’s defense mechanism against germs.
• Surgery: Performed as the last resort when the condition is no longer manageable with oral medications and I.V. shots.

Lifestyle Modifications:

Following the below-mentioned tips will make hidradenitis suppurative (HS) significantly less severe with few outbreaks:

• Quit smoking
• Wear breathable, loose clothes
• Shed unhealthy weight
• Spare shaving trouble spots
• Maintain hygiene

Outlook:

Hidradenitis suppurative (HS), despite being a rare disease can significantly impact your quality of life if left untreated. Therefore, early treatment is the best remedy to arrest the progression and lower the risk of flare-ups. There is no definitive test for diagnosing hidradenitis suppurative (HS) however, turning to your practitioner at the right time is the best way to obtain treatment 

Additionally, paid clinical trials may be a good option to explore potential treatment options.