University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Tom Colletti, DHSc, MPAS, PA-C, DFAAPA


Hidradenitis suppurativa (HS) is a chronic, inflammatory dermatologic disease primarily affecting the intertriginous areas of skin via bacterial infection and inflammation of apocrine glands. More common in women, this disease can present with an abundance of draining abscesses, lesions, boils, and nodules most commonly in the axillary, inguinal, gluteal, and inframammary folds. HS is diagnosed based on patient history and physical exam. Recurrent bouts of HS can lead to the formation of sinus tracts underneath the skin and visible scarring in the affected areas, which can lower self-esteem and even cause depression and anxiety in patients. HS can be debilitating for patients and difficult to manage medically due to the acute emergence and recurrence of painful lesions. Therefore, treatment can be laborious and ever changing, frustrating for patients and providers alike. Common treatment options include intralesional Kenalog, topical clindamycin, tetracycline antibiotics, and tumor necrosis factor-alpha inhibitors. Surgery is another option for patients who fail medical treatment. Inflammatory bowel disease, polycystic ovary syndrome, atherosclerosis, and obesity are some of the most common comorbidities associated with HS. HS can also be mistaken for other dermatologic diseases, such as acne vulgaris, folliculitis, and pilonidal or Bartholin gland cysts, causing a delay in treatment. This review will provide a guide for healthcare professionals to aid in recognizing, diagnosing, and treating HS.


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