It causes a mixture of recurrent red boil-like painful lumps, blackheads, cysts, scarring and channels in the skin that leak pus & main affects the axilla, groin & inner thighs, buttocks, and under the breasts.
Hyperkeratosis of the infundibulum, leading to follicular occlusion of the pilosebaceous unit plays a role in the pathogenesis secondary infected with bacteria like staphylococci, Escherichia coli and streptococcus, Smoking and obesity are both known as risk factors and are associated with more severe disease course.
Hidradenitis Suppurativa Treatment
Pain management, weight loss, tobacco cessation, treatment of super infections, and application of appropriate dressings is considered to be the main stay of the treatment.
Topical Clindamycin 1 % solution/gel b.i.d. for 12 weeks or Tetracycline 500 p.o. b.i.d. for 4 months , for more widespread disease.
If patient fails to exhibit response to treatment or for a PGA of moderate-to-severe disease, Clindamycin 300 p.o. b.i.d. with Rifampicin 600 p.o. o.d. for 10 weeks.
If patient is not improved, then Adalimumab 160 mg at week 0, 80 mg at week 2; then 40 mg subcutaneously weekly should be administered. If improvement occurs then therapy should be maintained as long as HS lesions are present. If the patient fails to exhibit response, then consideration of second or third line therapy is required.
Dr Sachin k Maurya, Medical Director, Antiaging skin clinic Group