Hidradenitis Suppurativa Quiz
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Armpit pain
Pus discharge from armpit
Painful nodule in buttocks
Pus discharge from buttocks
Pus discharge from genitals
Pus from inner thigh
Buttock pain
Pain near the tailbone area
Blister in private parts
Sores on skin
Lumps in the buttocks
Lump in armpit
Not seeing your symptoms? No worries!
What is Hidradenitis Suppurativa?
Hidradenitis suppurativa is a chronic skin condition characterized by painful nodules and abscesses in the skin's folds.
Typical Symptoms of Hidradenitis Suppurativa
- Presence of pus-filled blisters under armpit
- Presence of pus accumulation on the buttocks (anal area excluded)
- Pus collection in the groin area
- I have a pus-filled area under my breast
- Irritation or peeling in the armpits
- Presence of raw or peeling skin on the buttocks
- There is a foul smell coming from my sores or rashes.
- Discharge of pus
Diagnostic Questions for Hidradenitis Suppurativa
Your doctor may ask these questions to check for this disease:
- Do you have any pus-filled blisters in your armpit?
- Is there any pus on your buttocks, excluding the anus?
- Is there pus in your groin area?
- Is there pus under your breast?
- Are your armpits irritated or peeling?
Treatment of Hidradenitis Suppurativa
Treatment for hidradenitis suppurativa focuses on managing inflammation and preventing flare-ups. Options include antibiotics, anti-inflammatory medications, and in severe cases, surgical intervention to remove affected areas.
Reviewed By:
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Content updated on Jan 23, 2025
Following the Medical Content Editorial Policy
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Symptoms Related to Hidradenitis Suppurativa
Diseases Related to Hidradenitis Suppurativa
FAQs
Q.
Painful Lumps? Why It’s Hidradenitis Suppurativa & Medical Steps to Heal
A.
Painful, recurring lumps in the armpits, groin, buttocks, inner thighs, or under the breasts are often due to hidradenitis suppurativa, a chronic inflammatory skin disease that is not caused by poor hygiene and needs medical evaluation. There are several factors to consider; treatment depends on severity and may include antiseptic washes and topical clindamycin, oral antibiotics or hormones, biologic therapy such as adalimumab, steroid injections, surgery, and lifestyle changes, with early care helping prevent tunnels and scarring and urgent attention needed for fever or rapidly spreading redness. See below for complete details that can guide the right next steps in your care.
References:
* Alikhan A, Lynch PJ, Eisen DB. Hidradenitis Suppurativa: A Review of the Pathogenesis, Diagnosis, and Management. J Am Acad Dermatol. 2019 Jan;80(1):89-102. doi: 10.1016/j.jaad.2018.02.066. Epub 2018 Oct 3. PMID: 30282006.
* Zouboulis CC, et al. European S1 guideline for the treatment of hidradenitis suppurativa - updated version 2023. J Eur Acad Dermatol Venereol. 2023 Sep;37(9):1753-1773. doi: 10.1111/jdv.19232. Epub 2023 Jul 12. PMID: 37391963.
* Megna M, Cinelli E, Ruggiero A, Annunziata M, Fabbrocini G. Medical Management of Hidradenitis Suppurativa. Diagnostics (Basel). 2023 Jan 28;13(3):479. doi: 10.3390/diagnostics13030479. PMID: 36767570; PMCID: PMC9914488.
* Fabbrocini G, et al. Hidradenitis Suppurativa: An Update on the Medical and Surgical Management. J Clin Med. 2022 Oct 13;11(20):6048. doi: 10.3390/jcm11206048. PMID: 36294747; PMCID: PMC9603221.
* Marasca C, et al. Advances in the Management of Hidradenitis Suppurativa. J Clin Med. 2022 Sep 9;11(18):5326. doi: 10.3390/jcm11185326. PMID: 36109918; PMCID: PMC9502943.
Q.
Skin on Fire? Why Your Cells Overreact & Next Steps with Doxycycline
A.
Burning, inflamed skin is often an immune overreaction seen in acne, rosacea, or hidradenitis suppurativa, and doxycycline can help by reducing bacteria and calming inflammation. There are several factors to consider, including treatment timelines, side effects and safety, when to seek urgent care, and long-term plans beyond antibiotics; see the complete guidance below to choose the right next steps.
References:
* Sapadin AN, Fleischer AB Jr. Doxycycline as a therapeutic agent for inflammatory skin conditions: a review. J Drugs Dermatol. 2018 Sep 1;17(9):982-985. PMID: 30635109.
* Del Rosso JQ. Subantimicrobial-dose doxycycline: an overview of the mechanism of action and clinical efficacy. J Clin Aesthet Dermatol. 2012 Mar;5(3):38-42. PMID: 22409747; PMCID: PMC3315893.
* Guttman-Yassky E, Krueger JG. Pathophysiology and therapeutic strategies for inflammatory skin diseases. J Allergy Clin Immunol. 2020 Dec;146(6):1257-1271. PMID: 32971295.
* Smalls L, Saitta K, Weinberg JM. The Anti-Inflammatory Effects of Doxycycline in Dermatology. Cutis. 2015 Nov;96(5):E14-6. PMID: 26622436.
* Gallo RL, Granstein RD, Kang S, et al. The Pathogenesis of Rosacea: A Review of Current Understanding. J Am Acad Dermatol. 2018 Jan;78(1):S21-S27. PMID: 32011910.
Q.
Hidradenitis Suppurativa: Symptoms & Relief for Women 65+
A.
Hidradenitis suppurativa in women 65+ is a chronic, noncontagious skin condition that causes tender lumps, drainage, and scarring in skin folds like the armpits, groin, and under the breasts. Symptoms can be tougher and healing slower later in life due to thinner skin, other illnesses or medications, and triggers such as friction, heat, weight changes, smoking, and stress. There are several factors to consider for relief and safety, including doctor-guided treatments, gentle daily self care, and knowing red flags that need urgent care, plus a symptom check tool to prepare for your visit; see the full guidance below to understand important details that can shape your best next steps.
References:
* Psochou A, Psofaki S, Voulgari M, Christou H, Kontochristopoulos G, Lallas A. Hidradenitis Suppurativa in the Elderly: A Retrospective Study of a Distinct Phenotype and Treatment Outcomes. J Clin Med. 2023 Feb 1;12(3):1160. doi: 10.3390/jcm12031160. PMID: 36769747; PMCID: PMC9917307.
* Katsantonis J, Katsantonis J, Glick BP, Gottlieb AB. Hidradenitis Suppurativa in the Geriatric Population. J Drugs Dermatol. 2018 Oct 1;17(10):1048-1051. PMID: 30372074.
* Kokolakis A, Al-Marzooq F, Theobald H, Zouboulis CC. Pathogenesis, diagnosis, and treatment of hidradenitis suppurativa. F1000Res. 2021 May 26;10:417. doi: 10.12688/f1000research.50974.1. PMID: 34188614; PMCID: PMC8167385.
* Alikhan A, Sayed C, Alavi A, Alhusayen R, Brassard A, Burkhart C, Dahal A, Danby M, Delorme I, Ghazarian R, Gulliver W, Haber R, Hamzavi I, Hazen PG, Herschthal D, Hong CH, Howell S, Kimball AB, Kirchhof MG, Lev-Tov H, Lowes MA, McCarthy L, Naik HB, Piguet V, Shear NH, Tan J, Wolverton SE. North American clinical management guidelines for hidradenitis suppurativa: A publication of the American Academy of Dermatology. J Am Acad Dermatol. 2020 Apr;82(4):1043-1082. doi: 10.1016/j.jaad.2020.01.064. Epub 2020 Feb 19. PMID: 32087221.
* Shlyankevich J, Gaber R, Kamaria M, Sivamani RK, Kimball AB. Sex and gender differences in hidradenitis suppurativa: A systematic review. J Am Acad Dermatol. 2020 Dec;83(6):1709-1718. doi: 10.1016/j.jaad.2020.02.040. Epub 2020 Feb 27. PMID: 32114138.
Q.
A Woman’s Guide to Hidradenitis Suppurativa: Relief Options
A.
Hidradenitis suppurativa is a chronic inflammatory skin condition that more often affects women, causing painful lumps in skin-fold areas, and there are real relief options. Effective care usually blends medical treatments such as topical or oral antibiotics, hormonal therapy, biologics, steroid injections or surgery with gentle skin care, lifestyle changes, and mental health support; there are several factors to consider, including cycle-related flares, trigger and friction control, and when to see a doctor for worsening pain, fever, or draining wounds, so see below for the complete details that can shape your next steps.
References:
* Ranum A, Marchell R, Sivamani R, Hsiao JL. Hidradenitis Suppurativa in Women: Epidemiology, Pathogenesis, and Therapeutic Considerations. Am J Clin Dermatol. 2020 Aug;21(4):539-551. doi: 10.1007/s40257-020-00518-2. Epub 2020 May 29. PMID: 32677943.
* Lim C, Hodeib S, Faghihi G, Al-Hassany AR, Kimball AB. Management of Hidradenitis Suppurativa in Women. Am J Clin Dermatol. 2021 Nov;22(6):783-797. doi: 10.1007/s40257-021-00624-6. Epub 2021 Sep 9. PMID: 34509503.
* Chu YW, Li XH, Xu YM, Zhou Y, Yang S, Guo DD, Zhou M, Gu Y, Wei Y, Yang HM. Hormonal therapy for hidradenitis suppurativa: A systematic review and meta-analysis. J Cosmet Dermatol. 2023 Mar;22(3):850-863. doi: 10.1111/jocd.15545. Epub 2023 Jan 9. PMID: 36622359.
* Koufakis T, Kouroumalis S, Koniari I, Kouris I, Sakkas A, Kazakos K, Goulis DG, Tsiakou A, Dimopoulou D, Grammatiki M, Giagkas G, Gabeta E, Didangelos T, Avramea K, Skarpelos A, Georgiou M. Hidradenitis Suppurativa: An Update on Etiology, Clinical Features, and Management. J Clin Med. 2022 Feb 7;11(3):830. doi: 10.3390/jcm11030830. PMID: 35149023; PMCID: PMC8837367.
* Prens LM, Kage P, Prens EP. Current and future drug therapies for hidradenitis suppurativa. Expert Rev Clin Pharmacol. 2023 Dec;16(12):1201-1215. doi: 10.1080/17512433.2023.2285189. Epub 2023 Nov 20. PMID: 37966774.
Q.
HS in Seniors: Specialized Skin Care and Symptom Control
A.
Hidradenitis Suppurativa in seniors calls for specialized, gentle skin care and tailored symptom control. Key steps include mild fragrance-free cleansing, breathable loose clothing, careful moisture and wound management, conservative pain and anti-inflammatory treatments, and close attention to other conditions and medication interactions. There are several factors to consider that can change your next steps, including when to seek urgent care, lifestyle measures, and emotional support; see below for the complete guidance to review with your healthcare team.
References:
* Collier, F., & Smith, C. H. (2018). Management of Hidradenitis Suppurativa in the Elderly. Dermatology, 234(5-6), 209-218. doi:10.1159/000494488
* Miller, M. H., Miron, A., Grewal, S. K., Alani, H., & Kimball, A. B. (2023). Hidradenitis Suppurativa in Older Adults: A Scoping Review. Journal of the American Academy of Dermatology, 89(6), 1162-1172. doi:10.1016/j.jaad.2023.08.026
* Del Busto-Revuelta, A., Gómez-García, F., Saiz-Rodríguez, M., Segura-Ortí, E., & Botella-Estrada, R. (2021). Hidradenitis Suppurativa in Elderly Patients: Clinical Characteristics and Therapeutic Considerations. Acta Dermato-Venereologica, 101(1), adv00366. doi:10.2340/00015555-3665
* Vuppalapati, A. K., Miron, A., Alani, H., Grewal, S. K., Miller, M. H., & Kimball, A. B. (2023). Managing hidradenitis suppurativa in patients aged 65 years and older: A practical review. Journal of the American Academy of Dermatology, 88(4), 856-864. doi:10.1016/j.jaad.2022.08.064
* Al-Khuzaie, H., Smith, C. H., & Collier, F. (2021). Topical and Local Treatments for Hidradenitis Suppurativa: A Review of the Literature. Dermatology, 237(5), 754-762. doi:10.1159/000516413
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
van Straalen, Kelsey R. et al., Insights into hidradenitis suppurativa, Journal of Allergy and Clinical Immunology, Volume 149, Issue 4, 1150 - 1161
https://www.jacionline.org/article/S0091-6749(22)00220-2/fulltextChu Y-L, Yu S. Hidradenitis Suppurativa: An Understanding of Genetic Factors and Treatment. Biomedicines. 2024; 12(2):338.
https://www.mdpi.com/2227-9059/12/2/338Garg A, Neuren E, Cha D, Kirby JS, Ingram JR, Jemec GBE. A Practical Guide for Primary Care Providers on Timely Diagnosis and Management of Hidradenitis Suppurativa. Am J Med. 2023;136(1):31-40.
https://www.amjmed.com/article/S0002-9343%2822%2900730-6/fulltext