Hidradenitis Suppurativa

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Hidradenitis Suppurativa (HS) is an inflammatory condition that can occur in both men and women, and most commonly affects the axilla (armpit) and groin region (hair bearing areas). It can also appear on the breast. HS generally involves painful, red, nodular lesions that may drain fluid and form persistent fistulae (connection from deeper tissue to outside world). In the past, we would perform large surgical excisions of these lesions that would often result in wound breakdown, significant scarring and mobility issues, and recurrence.

Hidradenitis after excision and scarring and mobility limitations
Scars from excision of hidradenitis affecting nipple areolar complex and axilla with patient having limited mobility of arm after this.
Hidradenitis axilla
Hidradenitis axilla

Now, we have learned this disease is more inflammatory in nature. Symptoms can be treated with steroid injections into the specific area of concern, and more severe cases can be treated with oral or intravenous medication.

Hidradenitis Suppurativa flaring
Before steroid injection
Hidradenitis Suppurativa After steroid
Three weeks after steroid injection
Hidradenitis Suppurativa in axilla
Hidradenitis Suppurativa in axilla (underarm)
Hidradenitis Suppurativa on breast
Less common presentation on breast (biopsied to confirm HS).
hidradenitis
Hidradenitis in the midline and inframammary fold.

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