Source: Seattle Post - Intelligencer
Dec 3, 2004

Dear Mayo Clinic:

I have a chronic condition, hidradenitis suppurativa, that I have been dealing with for 21/2 years. I have had two unsuccessful surgeries to drain the infection, which caused me a great deal of pain and provided no results because the blisters returned in the same exact place (my groin area) just three short days later.

I've had corticosteroid injections from my dermatologist, which only provided me with temporary relief. I've been on every antibiotic that there is for extensive amounts of time, which also did not help but instead caused other issues. I have been to several doctors, gynecologists and dermatologists and no one seems to be able to help me.

I refuse to give up hope and accept the answer "some people are just prone to this type of thing, so deal with it." There has to be some cure for this - I know I'm not the only sufferer in the world with this skin condition. If you have seen or successfully treated this annoying disease, I would greatly appreciate hearing about it.

Chicago
 

Answer:

Yes, we see patients with this condition, and the frustration you voice is common. Based on the partial description you provide, I would recommend you discuss with your physician the possibility of having surgery to remove the most involved areas.

"Hidradenitis" is the medical term for inflammation of hair follicles, oil ducts and sweat glands in the skin. The term "suppurativa" means that the infection causes pus to form. Hidradenitis suppurativa typically begins at or after puberty, and many cases are hereditary. HS consists of multiple blackheads, pustules and abscesses on the skin, which lead to pain and scarring. Folded skin areas - underarms, groin, buttocks and under the breasts - are often involved. Obesity and smoking aggravate this disease.

Standard treatment options include: topical retinoids and antibiotics; systemic antibiotics chosen based on cultures taken from the wounds; injections of corticosteroids; incision and drainage procedures; and systemic retinoids. Most recently, doctors have begun using anti-tumor necrosis factor medications to treat HS.

Many physicians feel that radical excision surgery should be done to remove very active areas - and the earlier it's done, the better. Patients also should see a dietitian for help losing weight. And if you smoke cigarettes, stop.

- Gabriel Sciallis, M.D., Dermatology, Mayo Clinic, Rochester, Minn.

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