title: [Hidradenitis suppurativa].
abstract: BACKGROUND
  Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by recurrent tender nodules and boils, usually in the armpits and groins. Draining fistulas and hypertrophic scarring are hallmarks of more severe disease. The objective of this article is to review the clinical presentation, diagnostic considerations and treatment of the disease.
  
  
  METHODS
  The article is based on a non-systematic literature search in PubMed, review of dermatology textbooks and the author's personal clinical experience.
  
  
  RESULTS
  Hidradenitis suppurativa, also known as acne inversa, is a follicular occlusion disease that can severely reduce quality of life. Staphylococci and other pathogenic bacteria frequently colonize the lesions, but the disease is not primarily a bacterial infection. Smoking and obesity can worsen disease activity. Moderate and severe disease is usually treated with excisional surgery. Antibiotics, often tetracyclines, are indicated for mild disease and as an adjunct to surgery in more severe disease. Antibiotics, however, are not curative. New treatment options, such as TNF-alpha inhibitors and zinc gluconate should still be considered experimental.
  
  
  CONCLUSIONS
  Hidradenitis suppurativa is probably underdiagnosed. The disease is often recalcitrant to treatment. The effect of medical treatment is not supported by high quality evidence.
authors.affiliation: Hudavdelingen, Haukeland universitetssykehus, 5021 Bergen. etolaas@broadpark.no
authors.forename: Erlend
authors.initials: E
authors.lastname: Tolaas
authors.forename: Cathrine Wold
authors.initials: CW
authors.lastname: Knudsen
authors.forename: Lisbet
authors.initials: L
authors.lastname: Sviland
authors.forename: Kim Alexander
authors.initials: KA
authors.lastname: Tønseth
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D018859:Hair Follicle / Q000473:pathology; D017497:Hidradenitis Suppurativa / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D012867:Skin / Q000473:pathology; D013514:Surgical Procedures, Operative / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents