Hidradenitis Suppurativa (huidontsteking)
- Article
- 2021-01-30
Hidradenitis suppurativa, also known as acne inversa, is a chronic, non-contagious, inflammatory condition characterized by pimple-like bumps or boils and tunnels or channels on and under the skin. Pus-filled bumps on the skin or hard bumps under the skin can develop into painful, inflamed areas (also called "lesions") with chronic drainage.
HS starts in the hair follicle in the skin. In most cases, the cause of the disease is unknown, although a combination of genetic, hormonal and environmental factors are likely to play a role in its development. The disease can significantly affect a person's quality of life.
Symptoms
In people with hidradenitis suppurativa, pus-filled bumps on the skin or hard bumps under the skin can develop into painful, inflamed areas (also called "lesions") with chronic drainage. In severe cases, the lesions can become large and connected by channels, which are narrow tunnel-like structures under the skin. In some cases HS leaves open wounds that will not heal. The disease can cause significant scarring.
HS usually occurs where two areas of the skin can touch or rub, usually the armpits and groin. Lesions can also form around the anus, on the buttocks or thighs, or under the breasts. Other less frequent sites of lesions can be the neck, the areola of the chest, the scalp, and the area around the navel.
Some people with relatively mild disease may have only one affected area, while others have more extensive disease with lesions in multiple locations. Skin problems from HS are usually symmetrical, meaning that if an area on one side of the body is affected, the corresponding area on the other side is also affected.
Therapy
The treatment of hidradenitis suppurativa is individualized and aimed at reducing skin lesions and preventing the progression of the disease. The options depend on several factors, including the severity and extent of the lesions and possible complications.
A TNF inhibitor, from a class of medications known as "biologics," has been approved for the treatment of moderate to severe HS. Other medications used in the treatment of HS include antibiotics, corticosteroids, immunosuppressants, retinoids, hormone therapy, and approved treatments for other medical conditions. Laser hair removal can also be helpful. Some patients take medications to treat pain related to the disease. Surgical techniques can help, such as "roof removal" (top off) of lesions, and wide excision of the affected area in more advanced cases.
Treatment often starts with a general practitioner; however, general practitioners often refer patients to dermatologists, especially in cases of more severe or difficult to treat disease.
Psychological counseling can be helpful for people dealing with the emotional effects of the illness.
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