10th July 2023

Hidradenitis Suppurativa (HS)

A skin condition that primarily affects the apocrine glands of the groin and axillae. It is characterised by persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring. Risk factors include obesity, cigarette smoking, family history (30%), African ethnicity, Crohn’s disease, and medications such as lithium and sirolimus. The lesions often present as comedones and painful papules that eventually progress into draining sinuses and scarring. Complications include pyogenic granulomas, secondary infections, lymphoedema and squamous cell carcinomas. Management involves lifestyle measures. Medical options include topical benzoyl peroxide, topical clindamycin, anti-androgen therapies, systemic steroids, ciclosporins and surgical drainage. The treatment of HS can often be challenging for clinicians and a multidisciplinary team approach is often needed.