eMedicine Specialties > Emergency Medicine > Dermatology

Hidradenitis Suppurativa: Differential Diagnoses & Workup

Author: Diana Fite, MD, FACEP, Clinical Assistant Professor, Department of Emergency Medicine, University of Texas Medical School at Houston, Hermann Hospital
Contributor Information and Disclosures

Updated: Mar 4, 2009

Differential Diagnoses

Candidiasis
Cellulitis
Erysipelas

Other Problems to Be Considered

Bacterial folliculitis and furunculosis
Granuloma inguinale
Lymphogranuloma venereum
Pilonidal cysts
Tuberculous inflammation of the skin
Carbuncle
Epidermoid or dermoid cyst

Workup

Laboratory Studies

  • Culture of any exudate obtained (if aspiration or drainage of larger nodules is necessary) will yield a variety of saprophytic and pathogenic bacteria with a preponderance of staphylococci and streptococci.
  • Thyroid function studies may be useful if clinically indicated because an association with Graves disease or Hashimoto thyroiditis may occasionally occur.
  • If a patient appears toxic or is febrile, laboratory tests should include the following:
    • CBC
    • Blood cultures
    • Culture of exudate
    • Routine chemistries

Procedures

  • Incision and drainage may be helpful for large, painful, fluctuant nodules that have not opened spontaneously.
  • Most nodules will resolve even without drainage.

More on Hidradenitis Suppurativa

Overview: Hidradenitis Suppurativa
Differential Diagnoses & Workup: Hidradenitis Suppurativa
Treatment & Medication: Hidradenitis Suppurativa
Follow-up: Hidradenitis Suppurativa
References
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References

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  2. Jemec GB. The symptomatology of hidradenitis suppurativa in women. Br J Dermatol. Sep 1988;119(3):345-50. [Medline].

  3. Shah N. Hidradenitis suppurativa: a treatment challenge. Am Fam Physician. Oct 15 2005;72(8):1547-52. [Medline]. [Full Text].

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  5. von der Werth JM, Williams HC. The natural history of hidradenitis suppurativa. J Eur Acad Dermatol Venereol. Sep 2000;14(5):389-92. [Medline].

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Further Reading

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Keywords

hidradenitis suppurativa, acne inversa, follicular occlusion, acne, pilonidal cysts, chronic scalp folliculitis, spiradenitis, apocrine glands, sweat glands, chronic acneiform infection, nodular lesions, cellulitis, excessive perspiration, Crohn disease, irritablebowel syndrome, Down syndrome, arthritis, Graves disease, Hashimoto thyroiditis, Sjögren syndrome, herpes simplex, Crohn's disease, Sjögren's syndrome

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Contributor Information and Disclosures

Author

Diana Fite, MD, FACEP, Clinical Assistant Professor, Department of Emergency Medicine, University of Texas Medical School at Houston, Hermann Hospital
Diana Fite, MD, FACEP is a member of the following medical societies: American Association of Women Emergency Physicians, American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Robert M McNamara, MD, FAAEM, Chair and Professor, Department of Emergency Medicine, Temple University School of Medicine
Robert M McNamara, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, Pennsylvania Medical Society, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark W Fourre, MD, Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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