Hidradenitis suppurativa.
BACKGROUND
Hidradenitis suppurativa (HS) is a recurrent, suppurative disease manifested by abscesses, fistulas, and scarring.


METHODS
We reviewed the literature to identify reliable information regarding epidemiology, pathogenesis, clinical manifestations, evaluation and differential diagnosis, treatment, complications, and prognosis.


RESULTS
Hidradenitis suppurativa usually affects young women, with a prevalence of 0.3% to 4% in industrialized countries. Once considered to be "apocrine acne," HS is actually a defect of terminal follicular epithelium. Obesity, chemical irritants, or hyperandrogenism are not consistently associated; bacterial involvement is secondary. Hidradenitis suppurativa should be suspected in young adults with recurrent, deep furuncular lesions in flexural sites, especially when such lesions respond poorly to antibiotic therapy. Clindamycin and isotretinoin may be useful, though wide excision with healing by granulation is considered most efficacious. Anemia, arthropathy, and squamous cell carcinoma are potential complications.


CONCLUSIONS
Since spontaneous resolution is rare and progressive disability the rule, early definitive surgical treatment of HS is advisable.
Brown
T J
TJ
Department of Dermatology, Baylor College of Medicine, and the Veterans Administration Medical Center, Houston, Tex 77030, USA.
Rosen
T
T
Orengo
I F
IF
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001050:Apocrine Glands / Q000473:pathology; D002981:Clindamycin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology; D005260:Female; D005667:Furunculosis / Q000473:pathology; D018859:Hair Follicle / Q000473:pathology; D017497:Hidradenitis Suppurativa / Q000209:etiology / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use; D007641:Keratolytic Agents / Q000627:therapeutic use; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D012737:Sex Factors
D000900:Anti-Bacterial Agents; D007641:Keratolytic Agents; D002981:Clindamycin; D015474:Isotretinoin