Medical Encyclopedia

Hidradenitis

What is hidradenitis?

Hidradenitis is a chronic inflammatory disease of apocrine glands, which is caused by Staphylococcus aureus. The most common type of hidradenitis is hidradenitis under arm, but possible localization of the disease is in the groin, around the navel, anus, nipples and neck. Other name for the disease - abscess tuberous.

Hidradenitis - a disease of the period of youth and maturity of the person. Apocrine glands begin to function only in adolescence and in old age their work goes. Accordingly, children and the elderly do not suffer from hidradenitis. Over 80% of cases - women aged 15-50 years, often at puberty, hormonal failure at menopause. The cause of most women's inclinations disease that there are more apocrine glands in women than men, puberty in girls occur earlier than in boys.

Symptoms of hidradenitis

  • Small dense nodules on the skin that itch and hurt when pressed - this is the initial stage of the disease.
  • A few days nodules increase in size (20 mm in diameter) are convex. There are weakness, headache, sometimes fever.
  • The skin swells in the affected areas, becomes red, hurts when touched, body temperature may increase - a stage of maturation.
  • If the inflammation affects the subcutaneous fat - phlegmon can occur; when lymph nodes are affected - lymphadenitis.
  • In severe cases, large components merge into one large pool of ulcers that is fraught with sepsis.

Causes of hidradenitis

Purulent hidradenitis is an inflammatory disease of the sweat glands, belongs to a group of pyoderma. which penetrates into the apocrine glands as a result of damage to the skin (abrasions, scratches, etc.) on the lymphatic system or excretory ducts. Bacteria begin to actively proliferate, causing inflammation with pus formation.

Hidradenitis

Factors that increase the risk hidradenitis:

  • Hyperhidrosis - excessive sweating.
  • The pH of sweat in the alkaline side.
  • Diabetes mellitus, dysfunction of the sex glands, thyroid, pituitary, pancreas.
  • Obesity.
  • Skin diseases - eczema, dermatitis, psoriasis.
  • Abrasions, scratches, accidental cuts with a knife, cuts while shaving armpits and bikini).
  • Weak immune system.
  • Lack of proper hygiene of the skin.
  • Excessive use of deodorants.
  • Work in muddy conditions.

Diagnostics

First of all, a blood test is carried out, which show an increase in erythrocyte sedimentation rate, an increase in the number of leukocytes in inflammatory process. Also it is absolutely necessary to the discharge of bacterial inoculation to determine the exact agent: Streptococcus, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli or Proteus rnirabilis. This is done for the proper selection of the drug in the treatment of hidradenitis with antibiotics. Differential diagnosis is very important: in the early stages hidradenitis may be confused with boils, carbuncles, felinozom, at a later stage - with actinomycosis, lymphogranuloma venereum, donovanosis.

Treatment of hidradenitis

In most cases hidradenitis flows painful, occasionally escalates. The disease does not resolve itself, it is necessary a medical or a surgical treatment.

In the first few days after the detection of infection it is recommended every 4-5 hours to warm the affected skin dry heat. When there is a hidradenitis armpit or around the navel it is recommended warm up the skin warmth of the sun, preferably in the morning in the evening for 20-30 minutes. It is very important to prevent the spread of infection to neighboring sweat glands. To do this, cut the hair on the adjacent areas to avoid moisture (refuse bathing, bathing in the shower by covering the affected skin plaster), nodules and wipe the skin around them with camphor spirit.

Treatment of hidradenitis with antibiotics

It is important to promptly seek medical attention. Doctors usually prescribe antibiotics hidradenitis. In acute hidradenitis if there were nodules, the injection of triamcinolone (3-5 mg/ml with the addition of lidocaine) applied topically. If there was an abscess - such injections, then the abscess is opened and drained in hospital.

Treatment of chronic hidradenitis with antibiotics:

  • Erythromycin - 250 mg 4 times a day or 500 mg three times a day for 1-2 weeks.
  • Minocycline - in a dosage of 100 mg 2 times a day.
  • Tetracycline - at a dose of 250 mg four times a day or 500 mg three times a day.
  • Triamcinolone – 3-5 mg/ml in injectable form.
  • Prednisone - in extreme cases, about 70 mg per day with gradual decrease in dosage.
  • Other antibiotics - oleandomycinum, lincomycin.

If it is determined that the causative agent of inflammation became aureus, it is assigned an additional immunotherapy: staphylococcal gamma globulin, staphylococcal vaccine, etc.

Surgical treatment of hidradenitis

If the usual small knots are formed, the treatment of hidradenitis with antibiotics is usually sufficient. But when purulent abscess is formed, surgical intervention is necessary. Initially, doctors perform opening and drainage of abscesses arising. Next - excision of fibroids and sinus tracts. In the chronic form of the disease, permanent recurrent complete removal of skin from the affected area is conducted. Skin grafts from healthy areas are performed on a remote place of the skin.

For the treatment of hidradenitis some physiotherapy techniques are used: UV-therapy, UHF, laser therapy, electrophoresis, magnetic therapy.

Complications

Without timely treatment, there was a small nodules increase in size, filled with pus - there is an abscess or phlegmon. In the complete absence of treatment of hidradenitis or independent autopsy of abscess, it is possible blood poisoning - sepsis, which is dangerous to human life.

Prevention of hidradenitis

  • Compliance with the basic rules of hygiene of the body. Particular attention should be paid to the skin under the arms.
  • Refrain from wearing tight underwear.
  • The fight against obesity.
  • Shaving razor good quality, perform this procedure carefully to avoid potential cuts and scratches - the skin can get infected through them.
  • Use a good deodorant in moderation. Excessive use of deodorants creates favorable microflora armpits for bacteria.
  • Overall strengthening of immunity, prevention of infectious diseases.

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