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Feature Article

Hidradenitis suppurativa: debilitating and challenging to treat

Victoria Harris, Andrew Lee, Shivam Kapila, Alan Cooper



Hidradenitis suppurativa is a debilitating chronic skin disease of intertriginous areas, which may be misdiagnosed as boils or ingrown hairs in the early stages. Treatment often requires a combination of lifestyle modifications, medications and laser or surgical interventions.

Key Points

  • Hidradenitis suppurativa (HS) is a debilitating chronic skin disease characterised by inflammatory nodules, abscesses, sinus tracts, comedones and fibrotic scarring.
  • HS lesions are most common in the axillae but can occur in any intertriginous area.
  • The cause of HS is not completely understood and is likely to be multifactorial; contributing factors may include obesity, smoking, hormonal fluctuation, inflammation and genetics.
  • The main clinical features supporting an HS diagnosis are a history of recurrent painful or suppurating lesions (typically deep-seated inflammatory nodules) in intertriginous areas, with a chronic or relapsing course.
  • There is no single efficacious therapy for HS and a combination of lifestyle modifications, medical and laser or surgical interventions is often required.
  • Referral to a dermatologist is recommended for patients with moderate to severe HS.

    Picture credit: © 89803714051/Dollar Photo Club. Model used for illustrative purposes only.