Hidradenitis Suppurativa
Definition
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent, painful, and inflamed skin lesions.
Pathology
→ Apocrine gland dysfunction → Keratin accumulation and glandular plugging → Acute inflammation and abscess formation → Chronic inflammation and scarring
Types
- Acne inversa: HS with features similar to acne, but with more severe inflammatory lesions.
- Apocrine hidradenitis: HS with involvement of apocrine glands.
- Follicular hidradenitis: HS with involvement of hair follicles.
Causes
→ Genetics → Hormonal factors → Obstruction of apocrine glands → Bacterial infection → Inflammation
Clinical Features
→ Recurring, painful, and inflamed skin lesions → Lesions often in apocrine gland-bearing areas → Intertriginous areas (armpits, groin, buttocks) → Abscesses and sinus tracts → Scarring
Investigations
→ Clinical examination → Imaging studies (MRI, CT scan) → Biopsy (histopathology)
Complications
→ Scarring and disfigurement → Recurrent infections → Osteomyelitis → Renal failure
Management
→ Medical management (antibiotics, retinoids) → Surgical management (incision and drainage, abscess removal) → Lifestyle modifications (weight loss, smoking cessation)
Surgical Management
→ Incision and drainage: → Incise the abscess → Drain the pus → Close the wound → → → →
Homoeopathic Therapeutic Approach
→ Arsenicum album: For acute inflammatory lesions → Hepar sulfuris: For suppurative lesions → Sulphur: For chronic and recurrent lesions