Diagnosis and management of hidradenitis suppurativa in women

Abstract

Hidradenitis suppurativa is a chronic inflammatory disease that disproportionately affects women of childbearing age. Hidradenitis suppurativa is characterized by painful nodules, abscesses, draining dermal tunnels, and scarring with a predilection for intertriginous sites, such as the axilla, groin, and breast regions. Delay in diagnosis and treatment of hidradenitis suppurativa often results in long-term sequelae leading to significant morbidity, and rarely mortality, in these patients. This clinical opinion suggests that obstetrician-gynecologists are uniquely poised to recognize early signs of hidradenitis suppurativa during routine well-woman examinations and initiate treatment or referral to dermatology. Herein, we provide clinical pearls for obstetrician-gynecologists caring for female patients with hidradenitis suppurativa, including strategies for comprehensive management and recommendations to improve the comfort of patients with hidradenitis suppurativa during examinations.

Co-Graft of Acellular Dermal Matrix and Split Thickness Skin Graft—A New Reconstructive Surgical Method in the Treatment of Hidradenitis Suppurativa

“…The global prevalence of HS has been reported in the 0.00033–4.1% range [ 5 , 6 ]. The exact etiology and pathogenesis of HS remains unclear [ 7 , 8 ]. The cause of follicular plugging is still under debate, although immune dysregulation, genetic factors, hormonal fluctuation, and environmental risk factors are thought to play a role [ 7 ].…”

“…The exact etiology and pathogenesis of HS remains unclear [ 7 , 8 ]. The cause of follicular plugging is still under debate, although immune dysregulation, genetic factors, hormonal fluctuation, and environmental risk factors are thought to play a role [ 7 ]. The most common sites affected by HS are: axillary, inguinoperineal, gluteal, submammary regions and the nape of the neck, waistband, and inner thighs [ 9 ].…”

Dapsone in Hidradenitis Suppurativa: A Systematic Review

“…Although consensus is still lacking on how follicular occlusion is triggered in HS, factors such as immune system dysregulation, genetics, hormonal fluctuations and specific environmental conditions have been implicated. The immune system dysregulation theory is supported by the presence of elevated levels of proinflammatory cytokines, including interleukin (IL)-1b, IL-12, IL-23, IL-17 and tumor necrosis factor alpha, in the inflammatory lesions [ 5 ]. The initial stages are characterized by painful subcutaneous nodules with recurrent flares, leading to the development of complications such as the formation of sinus tracts and fibrous scars [ 6 ].…”

Hidradenitis suppurativa: Basic considerations for its approach: A narrative review

“…Studies have shown that the majority of HS patients visited a physician at least five times before receiving a diagnosis and the average time before diagnosis was around seven years [ 5 , 6 ]. If not treated in time, HS can lead to severe long-term sequelae such as genitourinary stenosis (in the case of affecting the genitourinary region) and an association with squamous cell carcinoma has even been described [ 7 ].…”