Hidradentis suppurativa is a disease of the apocrine sweat glands. It was first diagnosed as a condition by Velpeau in 1839 and in 1854 was associated with a peculiar inflammation of the sweat glands by Verneuil, who also named the disease. Hidradenitis suppurativa is sometimes referred to as: apocrinitis, apocrine acne, Verneuil's disease, Velpeaus disease, Fox-den disease, acne inversa or hidradenitis axillaris. Although not a fatal disease the ramifications, both physical and emotional, that accompany hidradenitis suppurativa, can prove difficult to overcome for people struggling with the condition. It is estimated to affect up to 3% of the world's population.
There are many theories about the causal factors for this condition, however a definitive cause remains elusive.
The disease affects the areas where the apocrine glands occur. During the first few weeks of foetal development these glands cover the entire body, but have receded and stabilised by the time of birth into the pubic regions. Here they stay dormant until puberty.
The onset of hidradenitis is found most commonly between the ages of 11 and 30, although cases have been documented in children as young as 2 years. Tender red nodules develop in the apocrine glands of the axillae (commonly in women), in the groin and on the buttocks (commonly in men), which are firm at first, but later become fluctuant, painful and eventually rupture discharging pus.
Hidradenitis develops in three stages and due to its insidious nature is normally misdiagnosed in its first stage as a single abscess or boil and is thus treated as such. It is only when the disease has reached stage II that the majority of accurate diagnoses are made.
The spread of the condition is by a mechanism known as sinus tracting. This is caused by the effect of bacterial infection, and pressure from the resulting abscesses, forcing a pathway under the skin surface and infecting other tissues of the body.
Stage I - Single or multiple abscess like growths in isolated incidences, with no scarring or sinus tract involvement. The possibility of long term remission at this stage is very high and people with the condition may have periods of up to several years between outbreaks.
Stage II - Multiple or single abscess like growths in multiple regions, with possible sinus tract scarring beginning to occur. This stage is characterised by infrequent periods of remission. It is at this stage that the majority of diagnoses are made.
Stage III - Multiple abscess like growths throughout the pubic areas; widely spread scarring from previous infections and formation of sinus tracts, giving rise to constantly weeping open wounds.
Hidradenitis suppurativa is not a contagious disease and cannot be transmitted from person to person.
There is no cure at present for the condition. However, if caught in the first stage, prompt surgical intervention can offer a good possibility of full remission.
Some treatments have met with limited success and it is important to consider possible side effects of any course of treatment.
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