Pathology
- Hidarenitis suppurativa
- Chronic recurrent infection of apocrine sweat glands
- Thought to be antigen-antibody reaction with blockage of follicular secretions
- Abcesses form recurrently and causes characteristic permanent disfiguration of the skin
- Usually affects young women
- Prevalence 0.3-0.4% in industrialised countries
Approach
- Examine as for any lump
- Inspect
- Skin thickened and may ulcerate
- "watering can" sinuses may be seen
- Look for signs of activa current infection (tenderness / increased temperature / erythema)
Completion
- Ask about symptoms arising from the condition - how it affects life
- Any other affected areas - groin, perineum
- Predisposing factors - diabetes
Treatment
- Well-localised abscess
- incision and drainage under antibiotic cover
- Large lesion
- radical excision and full-thickness skin graft usually harvested from groin or abdomen