HIDRADENITIS SUPPURATIVA |
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General Information
DEFINITION--A skin disorder characterized by nodules in the armpit. Athletes are more likely to develop the disorder because of excessive sweating and moisture.
SIGNS & SYMPTOMSNodules with the following characteristics:
Nodules are firm, tender and domed.
Nodules are 1cm to 3cm in diameter.
Larger nodules soften in the center and become painful. When pressed, they feel like an overfilled inner tube.
Nodules open and drain pus spontaneously.
Individual nodules (with or without drainage) heal slowly over 10 to 30 days.
Nodules leave scars.
Severity of the disorder varies from a few lesions per year to a constant succession of lesions that form as old ones heal. Lesions frequently recur at the same site.
CAUSES & RISK FACTORS
Hormonal influences that activate the apocrine glands under the arms. Secretions in these glands enlarge the gland. The outlets become blocked, probably by heat, sweat or incomplete gland development. The secretions that are dammed in the glands force sweat and bacteria into surrounding tissue, which becomes infected.
Repeated injury to the skin of athletes due to excessive heat, perspiration and friction of clothing and protective gear.
Obesity.
Exposure to environmental heat and moisture.
Genetic factors. This disorder is most common in black females.
HOW TO PREVENTNo specific preventive measures.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory culture of the discharge from the draining abscess.
SURGERYOften necessary to open and drain abscesses. Surgery is necessary to remove involved skin in desperate cases only.
NORMAL COURSE OF ILLNESS
This disorder may last many years -- from puberty through the following 10 to 20 years. Symptoms can be controlled with treatment.
POSSIBLE COMPLICATIONSScarring.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTNone is usually necessary after diagnosis and prescription of medications. Surgery is helpful in some cases.
HOME TREATMENT
Don't use commercial underarm deodorants or antiperspirants.
Wear cotton shirts or shirts without sleeves to prevent accumulation of sweat in the armpits during exercise.
Avoid constrictive clothing.
Lose weight if you're overweight.
Apply warm-water compresses to soothe pain or inflammation. Cool-water soaks feel better for itching.
MEDICATIONYour doctor may:
Inject corticosteroid drugs directly into the lesions.
Prescribe antibiotics to fight infection.
Prescribe hormones to help subdue inflammation.
Provide instructions for acceptable deodorant protection.
Prescribe pain medication. For minor discomfort, you may use non-prescription drugs such as acetaminophen.
ACTIVITYRestrict your activity in extremely hot weather. Swimming is an excellent substitute exercise, especially swimming in a warm ocean.
DIETNo special diet unless you need to lose weight.
CALL YOUR DOCTOR IF
You have symptoms of hidradenitis suppurativa.
Lesions don't improve after 5 days of treatment.
Your temperature rises to 101F (38.3C).
Lesions appear that become soft and seem to have pus, but don't drain spontaneously.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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