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Purulent hidradenitis (HS)

Overview of purulent hidradenitis

Hidradenitis suppurativa, also known as HS and more rarely as acne inverse, is a chronic, non-contagious inflammatory condition characterized by painful bumps or boils and tunnels in and under the skin. Pus-filled bumps on the skin or hard bumps under the skin can progress to painful, inflamed areas (also called "lesions") with chronic discharge.

HS starts in the hair follicle of the skin. In most cases, the cause of the disease is unknown, although a combination of genetic, hormonal, and environmental factors probably play a role in its development. The disease can significantly affect a person's quality of life.

Who gets sick with purulent hidradenitis?

Hydradenitis suppurativa affects about three women for every man and is more common in African Americans than whites. HS often appears during puberty.

Having a family member with the condition increases the risk of developing HS. It is estimated that one third of people with HS have a relative with the condition.

Smoking and obesity may be associated with HS. Obese people tend to have more severe symptoms. GS is not contagious. Poor personal hygiene does not cause HS.

Symptoms of purulent hydradenitis

In people with hidradenitis suppurativa, pus-filled bumps on the skin or hard bumps under the skin can progress to painful, inflamed areas (also called "lesions") with chronic drainage. In severe cases, the lesions can become large and connect with narrow tunnel structures under the skin. In some cases, HS leaves open wounds that do not heal. HS can cause significant scarring.

HS tends to occur where two areas of skin may touch or rub against each other, most commonly in the armpits and groin. Lesions may also form around the anus, on the buttocks or upper thighs, or under the breasts. Other less commonly affected areas may include behind the ear, back of the head, breast areola, scalp, and 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 in HS are usually symmetrical, meaning that if an area on one side of the body is affected, the corresponding area on the opposite side is often also affected.

Causes of purulent hydradenitis

Purulent hydradenitis begins in the hair follicle of the skin. The cause of the disease is unknown, although it is likely that a combination of genetic, hormonal and environmental factors play a role in its development.

It is estimated that one third of people with HS have a family member with a history of the disease. The disease appears to have an autosomal dominant pattern of inheritance in some affected families. This means that only one copy of the altered gene in each cell is needed for the disorder to occur. A parent who carries the altered gene has a 50 percent chance of having a child with the mutation. Researchers are working to determine which genes are involved.