Hydradenitis Suppurativa - Secretory Disorders

HYDRADENITIS SUPPURATIVA

A condition called hydradenitis suppurativa can occur in certain individuals. The cause is unknown.

Pathophysiology

Abnormal blockage of the sweat glands causes recurring in-flammation, nodules, and draining sinus tracts. Eventually, hy-pertrophic bands of scar tissue form in the area of the sweat glands.

Clinical Manifestations

The condition occurs more frequently in the axilla but also appears in inguinal folds, on the mons pubis, and around the buttocks. The patients can be extremely uncomfortable with multiple suppurative lesions within a small area. This condition does not appear before puberty and does appear to have a genetic basis.

Management

Management is difficult. Hot compresses and oral antibiotics are used frequently. Isotretinoin (Accutane) or etretinate can be tried; careful monitoring for side effects is important. Incision and drainage of large suppurating areas with gauze packs inserted to facilitate drainage is often necessary. Rarely, the entire area is ex-cised, removing the scar tissue and any infection. This surgery is drastic and attempted only as a last resort (Hall, 2000).