[Hidradenitis suppurativa].
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.
Tolaas
Erlend
E
Hudavdelingen, Haukeland universitetssykehus, 5021 Bergen. etolaas@broadpark.no
Knudsen
Cathrine Wold
CW
Sviland
Lisbet
L
Tønseth
Kim Alexander
KA
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
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents