title: Hidradenitis suppurativa: an update.
abstract: Hidradenitis suppurativa (HS) is a chronic, painful skin disease characterised by recurrent inflammatory lesions in flexural locations such as the axillae, groins and perineum. The papules, nodules and abscesses may discharge blood-stained pus which, combined with pain, results in marked quality-of-life reduction. Sinus tracts and scarring may also result. Onset of HS is typically in the second to fourth decades and it affects about 1% of young European adults. There are links with smoking and obesity and an autosomal dominant pattern of inheritance is reported by one-third of patients. Medical management escalates from topical antimicrobials to oral tetracyclines, a combination of clindamycin and rifampicin typically given for 10 weeks, oral disease modifiers, and anti-tumour necrosis factor-alpha therapies. Excision of individual lesions has high recurrence rates which can be minimised by wider excisions, at the expense of longer healing times. Treatment of pain is a relatively neglected aspect of therapy.
authors.affiliation: Department of Dermatology and Wound Healing, Division of Infection and Immunity, Cardiff University, Cardiff, UK ingramjr@cardiff.ac.uk.
authors.forename: John R
authors.initials: JR
authors.lastname: Ingram
mesh_terms: D000328:Adult; D001365:Axilla / Q000473:pathology; D005260:Female; D017497:Hidradenitis Suppurativa / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D009765:Obesity; D059408:Pain Management; D011788:Quality of Life; D012307:Risk Factors; D012867:Skin / Q000473:pathology; D012907:Smoking
keywords: Hidradenitis suppurativa; gamma secretase; pain; quality of life
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