Last reviewed: 2 Oct 2024
Last updated: 07 Jan 2022
Summary
Definition
History and exam
Key diagnostic factors
- at-risk demographic
- history of acne vulgaris
- recurrent disease
- poor response to previous antibiotic therapy
- open comedones in intertriginous (axilla, groin, perineum, or inframammary) areas
- nodules or abscess
- symmetrical distribution
- sinus tracts with scarring
Full details
Other diagnostic factors
- premenstrual flare
Full details
Risk factors
- obesity
- female sex
- smoking
- positive family history
- African-American
Full details
Diagnostic tests
Tests to consider
- bacterial culture
- skin biopsy
Full details
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.
Differentials
- Acne vulgaris
- Crohn disease
- Inverse psoriasis
More DifferentialsGuidelines
- Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization - systematic review and recommendations from the HS ALLIANCE working group
- Guidelines for the management of hidradenitis suppurativa (acne inversa)
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