Hidradenitis suppurativa

1. Hidradenitis suppurativa
Pathogenesis
• Disordered folliculopilosebaceous units:
• Ductal keratinocyte proliferation → follicular
occlusion → follicular rupture → inflammation
• Risk factors: smoking, metabolic syndrome (obesity,
diabetes)
Clinical
presentation
• Chronic & recurrent lesions in intertriginous areas
• Mild: painful nodules, draining abscesses
• Moderate: sinus tracts & scarring
• Severe: extensive sinus tracts, widespread disease
Treatment
• Mild: topical clindamycin
• Moderate: oral tetracycline
• Severe: tumor necrosis factor-α inhibitors (eg,
adalimumab), surgical excision
Complications
• Depression & suicide
• Squamous cell carcinoma of skin