Also known as acne inversa. Chronic, relapsing inflammatory dermatosis mainly affecting skins areas with apocrine glands such as the axilla, groin, perineum and anterior chest. It is a debilitating condition with an adverse effect on quality of life and remains difficult to treat as effective therapies are lacking.
The pathology is complex and the precise mechanism of disease is still a topic of research. This is controversy over the name, with some regarding hidradenitis suppurativa as a misnomer as they feel the underlying pathology is not suppurative inflammation of the apocrine glands, but rather due follicular blockage.
- Long term antibiotics (palliate rather than cure)
- Retinoids, e.g. acitretin (?no evidence for isotretinoin)
- Steroids (for acute flare-ups)
- Biological agents, e.g. ciclosporin, infliximab
Wide local excision with healing by secondary intention.