Hidradenitis suppurativa is a chronic inflammatory disease characterized by the formation of abscesses in the sweat glands, most often in the armpits, groin area and under the mammary glands. This disease occurs as a result of blockage of the excretory ducts of the sweat glands and subsequent infection, which leads to the formation of purulent foci. Hidradenitis suppurativa is manifested by periodic relapses, which can significantly worsen the quality of life of patients. The disease most often affects young people, especially women, and has a persistent tendency to become chronic.
History of the disease and interesting historical facts
Hidradenitis suppurativa was first described by Dr. Franklin in 1834 as an inflammation of the sweat glands, but the understanding of the nature of the disease developed gradually. In the 20th century, the pathology was first associated with genetic factors and excessive sweating. Cases of hidradenitis suppurativa observed in famous people are recorded in medical literature, which emphasizes its significance, despite its rarity in the population. Interestingly, approaches to treating this disease have varied over the centuries: from simple surgical interventions in the early 20th century to modern minimally invasive techniques used today.
Epidemiology
According to modern research, hidradenitis suppurativa occurs in 1-4% of the population. This disease is more common in women (the ratio of men to women is 1:3) and usually begins between the ages of 20 and 40. The results of epidemiological studies show that the incidence varies depending on the region: in countries with a warm climate, the incidence can reach up to 5%. The studies also confirm the presence of a link between hidradenitis suppurativa and other systemic diseases, such as metabolic syndrome.
Genetic predisposition to this disease
Today, it is known that hidradenitis suppurativa has a partial genetic predisposition. Studies have found a link with several genes, including IL-12B and CARD14, which are involved in the immune response and inflammatory processes. Mutations in these genes can disrupt the normal regulation of inflammation, contributing to the development of hidradenitis. It has also been established that having a family history of the disease increases the risk of developing it in offspring, confirming the hypothesis of a genetic component in the pathogenesis of the disease.
Risk factors for the development of this disease
Risk factors for the development of hidradenitis suppurativa can be divided into several groups:
- Physical factors: excessive sweating or hyperhidrosis, obesity, skin friction.
- Chemical factors: use of aggressive cosmetics, antidepressants and other drugs that affect sweating.
- Individual factors: smoking, stress, chronic infections.
- Comorbidities: metabolic syndrome, diabetes, inflammatory bowel disease.
Diagnosis of this disease
The diagnosis of hidradenitis suppurativa is primarily based on clinical examination and anamnesis. The main symptoms include:
- Formation of painful nodules or abscesses within the area of the sweat glands.
- Presence of purulent exudate.
- Chronic itching and burning in the affected areas.
Laboratory tests may include a complete blood count (which may reveal an elevated white blood cell count) and pus culture to identify the pathogen. Radiological tests, such as ultrasound, may help assess the size and depth of abscesses. Differential diagnosis should include other skin conditions, such as furunculosis or folliculitis.
Treatment
The approach to treating hidradenitis suppurativa is determined individually and may include:
- General treatment: lifestyle changes (weight loss consultations), adherence to hygiene measures.
- Pharmacological treatment: antibiotics if there is an infection, non-steroidal anti-inflammatory drugs for pain relief.
- Surgical treatment: drainage of abscesses, excision of affected tissues.
- Other types of treatment: laser therapy, immunotherapy.
List of medications used to treat this disease
Treatment for hidradenitis suppurativa may include the following medications:
- Antibiotics: clindamycin, tetracycline.
- NSAIDs: ibuprofen, naproxen.
- Immunosuppressants: methotrexate.
- Corticosteroids: prednisolone.
Disease monitoring
Monitoring the progress of hidradenitis suppurativa involves regular check-ups with a dermatologist and keeping a symptom diary. The prognosis can vary, but most patients experience recurrent disease, which can lead to complications such as postpartum infections or the development of other chronic skin conditions.
Age-related features of the disease
Hidradenitis suppurativa most often manifests itself at a young age, with a peak incidence at 20-30 years. In older people, the disease may be less pronounced, but the risk of complications increases due to exacerbation of other chronic diseases.
Questions and Answers
- What are the main symptoms of hidradenitis suppurativa? The main symptoms include painful nodules or abscesses, purulent exudate and itching in the affected areas.
- What diseases require differential diagnosis? Differential diagnosis should include furunculosis, folliculitis and other dermatological conditions.
- What are the treatment options for hidradenitis suppurativa? Treatment may include antibiotics, surgery, and lifestyle changes.
- Can hidradenitis suppurativa go away on its own? In rare cases, the disease can resolve on its own, but more often it requires complex treatment.
- After what age does this disease most often occur? Hidradenitis suppurativa is most often observed in young people aged 20-30 years.
Advice from Dr. Oleg Korzhikov
For effective treatment and prevention of recurrence of hidradenitis suppurativa, I advise my patients the following:
- Monitor your stress levels regularly: using relaxation techniques can reduce the likelihood of flare-ups.
- Maintain a separate hygiene regime: use antibacterial products for the body.
- Maintain a healthy weight: Reducing the stress on your skin can reduce your risk of disease.
- If you experience the first symptoms, contact your doctor immediately: early intervention can prevent the development of complex forms of the disease.
These recommendations may help reduce the risk of recurrence and improve the quality of life of patients with hidradenitis suppurativa.
