RT Journal Article
SR Electronic
T1 Hidradenitis suppurativa: an update
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 70
OP 73
DO 10.7861/clinmedicine.16-1-70
VO 16
IS 1
A1 John R Ingram
YR 2016
UL http://www.rcpjournals.org/content/16/1/70.abstract
AB 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.