Hidradenitis suppurativa

Revision as of 18:31, 12 July 2023 by Rossdonaldson1 (talk | contribs) (→‎Differential Diagnosis)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)

Background

  • Inflammatory condition involving the apocrine gland-bearing areas of skin, characterized by recurrent painful draining nodules.[1]
  • More common in women and black or biracial individuals.[2]
  • Rarely occurs before puberty. Peak age of onset is 11–20 yo in women and 21–30 yo in men.[3]

Clinical Features

Hidradenitis suppurativa of armpit
Hidradenitis suppurativa
Armpit with hidradenitis suppurativa.
Infected area of hidradenitis suppurativa with underlying pus.
  • Tender, nodular lesions most often in the axillae (can also affect gluteal folds, inframammary areas, perianal area, and pubic/genitofemoral areas)
  • Malodorous drainage
  • Pruritis
  • Burning
  • Erythema
  • Hyperhidrosis
  • Scarring[4]

Differential Diagnosis

Skin and Soft Tissue Infection

Look-A-Likes

Evaluation

  • Clinical diagnosis: skin nodules in characteristic sites, may have malodorous drainage
  • Diagnosis may be difficult in the ED if single nodule is present.

Management


Disposition

  • Discharge with primary care/dermatology followup

See Also

External Links

References

  1. Morrell D, Bowers E. Skin disorders: Groin and skinfolds. In Tintinalli J,ed. Tintinalli's Emergency Medicine: A Comprehensive Study Guide (8th ed). New York: McGraw Hill Medical; 2011: 1669-70.
  2. Garg A, et al. JAMA Dermatol. 2017;153:760–4.
  3. Palmer R, Keefe M. Clin Dermatol. 2001;26:501–3.
  4. *Shah, N. Hidradenitis suppurativa: A treatment challenge. Am Fam Physician. 2005 Oct 15;72(8):1547-1552.
  5. Morrell D, Bowers E. Skin disorders: Groin and skinfolds. In Tintinalli J,ed. Tintinalli's Emergency Medicine: A Comprehensive Study Guide (8th ed). New York: McGraw Hill Medical; 2011: 1669-70.