Hidradenitis Suppurativa: Living With Hope

Hidradenitis suppurativa, also known as acne inversa, refers to an inflammatory skin disease which targets the apocrine gland-bearing skin in the areas of axillae (armpits), under the breasts, and groin. The features of this skin condition include re-appearing boil-like nodules and abscesses that turn into pus-like discharge and scars, as well as sinuses (difficult-to-heal open wounds). Hidradenitis suppurativa also causes a significant amount of psychological stress, which leads to problems with body image, anxiety, and depression.

Hidradenitis suppurativa usually begins with puberty and becomes most active during the ages of 20 to 40. Women are three times more likely to be affected by hidradenitis suppurativa in comparison with men. Risk factors include genetic predisposition, smoking, obesity, insulin resistance and metabolic syndrome, Crohn disease (inflammatory bowel disease), and follicular occlusion disorders.

The treatment of hidradenitis suppurativa includes general measures such as weight loss and smoking cessation, in addition to medical and surgical treatments.

The medical management of hidradenitis suppurativa is a challenging and long-term process. It may include topical and systemic treatments comprising antibiotics, systemic retinoids, and immunomodulatory agents. One such agent is the biologic adalimumab, known as Humira, which was approved for the treatment of this condition several years ago.

The surgical management of hidradenitis suppurativa includes the incision and drainage of acute abscesses; laser ablation and curettage of nodules, sinuses, and abscesses; wide local excision of persistent nodules; and radical excisional surgery of the entire target zone.

Hidradenitis Suppurativa Awareness Week is dedicated each year to patients living with this disease. The #HSHope hashtag is used to share awareness and support.