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Skin Care and Diseases

Hidradenitis Suppurativa

03/23/2006

Question:

My daughter has been diagnosed with Hidradenitis Suppurativa a devastating orphan disease causing boil-like cysts in the sweat glands. She has had one the size of an egg surgically removed.

Do you have any information on this, i.e. treatment, cure?

Answer:

The causes of hidradenitis are probably related to genetic predisposition and the adult hormones, particularly androgens.  In the last several years the biologic Imiquimod has been found to be very effective in helping this disorder....much more effective than the previous use of retinoids such as Accutane. 

If the lesions are isolated, then simple excision may be curative; but if new lesions are developing in the axilla, groin and breasts then more intensive care needs to be undertaken. 

Your daughter should be evaluated very carefully by a board certified dermatologist to (1) determine that this is in fact the disease process, (2) determine its extent, and (3) suggest a number of treatment possibilities ranging all the way from intralesional injection, birth control pills, anti-androgens, etc. The choice of biologic should be made if your daughter's health is good....a number of other health criteria may be involved.

You can certainly read about the disease in some detail by going to your public library to the medical book section, starting with a full textbook on dermatology and reading the section on hydradenitis.  You might wish to also do a MedlinePlus search.  Your community librarian can help you with that to allow you to read a number of papers related to the disease. 

Please see your board certified dermatologist at your earliest convenience for a complete evaluation and therapy recommendation.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati