Hidrosadenita suppurativa

Hidrosadenita suppurativa

    * Introduction
    * Symptoms and Diagnosis
    * Treatment
Hidrosadenita suppurativa is a disease of the apocrine follicles. It is characterized by follicular occlusion comedoamelor similar, recurrent chronic inflammation, scarring and progressive elimination mucopurulent. Prone to chronic disease is due to subcutaneous extension leading to induration, sinus and fistula formation.
The exact cause is not determined hidrosadenitei suppurative. Them into account is the local friction, folliculitis, diabetes, obesity as a aetiological factors. Onset after puberty when the apocrine sweat glands begin to develop. Early lesions are solitary painful nodules form, prurigeni that persists for months without change. If the condition extends subcutaneous indurated plates appear. Nodules will blister and mucopurulent material will be removed from the outside. Areas affected include axial, inguinal, periareolar, intermamara, gluteal folds.
Nodules require surgical drainage of suppurative hidrosadenita if they are large, moving and painful. Antibiotics are indicated if cellulitis or fever is present and the patient appears to be toxic. In severe cases, radical excision is indicated. May is the therapeutic options of radiotherapy and laser therapy together. If sepsis or toxic state such as intravenous antibiotic indicate vancomycin, piperacillin and tazobactamul. Solitary lesions usually heal spontaneously in 10-30 days with or without drainage. Recurrence is common. Complete spontaneous resolution occurs in fewer cases.
Pathogenesis and causes The condition is considered to begin when apocrine gland ducts become blocked by perspiration or can not drain normally because of incomplete development. Secretions trapped in the glands force perspiration and bacteria into surrounding tissue causing subcutaneous induration, inflammation and infection. Recent studies show that hidrosadenita is caused first of follicular occlusion that blocks the follicles and apocrine glands and cause perifoliculita. The disease is limited to anatomical areas that contain apocrine glands. These areas are armpits, areola, inguinal, perineal, and periombilicale circumanal. Occasionally these patients shows and acne, chronic folliculitis of the scalp, pilonidal cyst, follicular occlusion tetrad. There is a genetic predisposition hidrosadenita suppurativa. Excessive perspiration is seen in athletes, obese, contributing to the blocking of apocrine glands. Condition is related to work stress and smoking.
Hidrosadenita diseases that are associated with include: -Crohn's disease, irritable bowel syndrome, Down syndrome -Some forms of arthritis, Graves disease, Hashimoto's thyroiditis -Sjogren syndrome, herpes simplex.
There are several theories on the etiology hidrosadenitei: Co-present foliculitei Local friction and trauma- -Streptococci, staphylococci, Escherichia coli -Diabetes, glucose intolerance and obesity -Hormonal changes during pregnancy and contraceptives Therapy and lithium-smoking predispose to hidrosadenita.