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Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a common (though rarely diagnosed), chronic skin disease characterized by clusters of abscesses or subcutaneous boil-like "infections" (oftentimes free of actual bacteria) that most commonly affects apocrine sweat gland bearing areas, such as the underarms, under the breasts, inner thighs, groin and buttocks.
Hidradenitis suppurativa commonly occurs around hair follicles, where many oil and sweat glands are found, such as in the armpits, groin and anal area.

Medical management of hidradenitis suppurativa is difficult. The aim is to catch the disease in its early stages and treat and control these milder forms. Antibiotics are usual therapy (partly to eradicate secondary bacterial infection and partly for their anti-inflammatory action) and long courses may be necessary. Weight loss in obese patients and smoking cessation are recommended.
On the basis of histological findings, the disease is now considered inflammatory and originating from the hair follicle; therefore, the term 'acne inversa' is favoured by some experts. The exact aetiology remains obscure but smoking seems to be a major triggering factor. Treatment should be individualized according to the site and extent of the disease. Absolute cessation of smoking is essential in the treatment of hidradenitis. Management with antibiotics or other medications may relieve early symptoms, but radical surgery may be necessary for control and to prevent recurrence.