Hidradenitis suppurativa
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Background
Hidradenitis suppurativa is an inflammatory condition involving the apocrine gland-bearing areas of skin, characterized by recurrent painful draining nodules.[1]
Clinical Features
- Tender, nodular lesions most often in the axillae (can also affect gluteal folds, inframammary areas, perianal area, and pubic/genitofemoral areas)
- Malodorous drainage
- Pruritis
- Burning
- Erythema
- Hyperhidrosis
- Scarring[2]
Differential Diagnosis
- Carbuncle
- Furuncle
- Epidermoid or dermoid cyst
- Erysipelas
- Granuloma inguinale
- Lymphogranuloma venereum
- Pilonidal cyst
- Tuberculosis (tuberculous inflammation of the skin)
Evaluation
- Clinical diagnosis: skin nodules in characteristic sites, may have malodorous drainage
- Diagnosis may be difficult in the ED if single nodule is present.
Management
- Clindamycin 1% topic
- Antibacterial soaps
- Systemic treatments (typically prescribed by specialist): acitretin, finasteride, prednisone
- Incision and drainage should be avoided if possible due to risk of scarring[3]
Disposition
- Discharge with primary care/dermatology followup
See Also
External Links
References
- ↑ Morrell D, Bowers E. Skin disorders: Groin and skinfolds. In Tintinalli J,ed. Tintinalli's Emergency Medicine: A Comprehensive Study Guide (8th ed). New York: McGraw Hill Medical; 2011: 1669-70.
- ↑ *Shah, N. Hidradenitis suppurativa: A treatment challenge. Am Fam Physician. 2005 Oct 15;72(8):1547-1552.
- ↑ Morrell D, Bowers E. Skin disorders: Groin and skinfolds. In Tintinalli J,ed. Tintinalli's Emergency Medicine: A Comprehensive Study Guide (8th ed). New York: McGraw Hill Medical; 2011: 1669-70.