Hidradenitis suppurativa

Last reviewed: 6 Jun 2022
Last updated: 07 Jan 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • recurrent disease
  • poor response to previous antibiotic therapy
  • open comedones in intertriginous (axilla, groin, perineum, or infra-mammary) areas
  • nodules or abscess
  • symmetrical distribution
  • sinus tracts with scarring
More key diagnostic factors

Other diagnostic factors

  • premenstrual flare
Other diagnostic factors

Risk factors

  • obesity
  • female sex
  • smoking
  • positive family history
  • African-American
More risk factors

Diagnostic investigations

Investigations to consider

  • bacterial culture
  • skin biopsy
More investigations to consider

Treatment algorithm

ACUTE

acute abscess

ONGOING

mild (Hurley stage I)

moderate (Hurley stage II)

severe (Hurley stage III)

Contributors

Authors

David Cassarino, MD, PhD

Consultant Dermatopathologist

Southern California Permanente Medical Group

Los Angeles Medical Center

Los Angeles

CA

Disclosures

DC declares that he has no competing interests.

Acknowledgements

Dr David Cassarino would like to gratefully acknowledge Dr Robert A. Lee, the previous contributor to this topic.

RAL declares that he has no competing interests.

Peer reviewers

David R. Adams, MD, PharmD

Associate Professor of Dermatology

Penn State Hershey Medical Center

Hershey

PA

Disclosures

DRA declares that he has no competing interests.

Ravi Ubriani, MD, FAAD

Assistant Professor of Clinical Dermatology

Columbia University

New York

NY

Disclosures

RU declares that he has no competing interests.

Andrew Carmichael, MB, BS

Consultant Dermatologist

James Cook University Hospital

Middlesbrough

UK

Disclosures

AC declares that he has no competing interests.

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  • Guidelines

    • North American clinical management guidelines for hidradenitis suppurativa part II: Topical, intralesional, and systemic medical management
    • Guidelines for the management of hidradenitis suppurativa (acne inversa)
    More Guidelines
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