Hidradenitis Suppurativa Questions & Answers

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Questions & Answers

Overview

What is hidradenitis suppurativa (HS)?

How is hidradenitis suppurativa (HS) characterized?

What is the onset and disease progression of hidradenitis suppurativa (HS)?

How is hidradenitis suppurativa (HS) diagnosed?

What are the primary diagnostic criteria for hidradenitis suppurativa (HS)?

What are the secondary diagnostic criteria for hidradenitis suppurativa (HS)?

How are the lesions of hidradenitis suppurativa (HS) characterized?

Which areas are most frequently affected by hidradenitis suppurativa (HS)?

Which questions can be used to diagnose hidradenitis suppurativa (HS)?

What is the Hurley clinical staging of hidradenitis suppurativa (HS)?

How are Sartorius Score systems used in the management of hidradenitis suppurativa (HS)?

What is the physician global assessment (PGA) for hidradenitis suppurativa (HS)?

Which staging system is recommended for the diagnosis and management of hidradenitis suppurativa (HS)?

What is the role of lab testing in the workup of hidradenitis suppurativa (HS)?

Which studies may be helpful in the workup of hidradenitis suppurativa (HS)?

What is the role of imaging studies in the workup of hidradenitis suppurativa (HS)?

What are the treatment options for hidradenitis suppurativa (HS)?

Does systemic treatment cure hidradenitis suppurativa (HS)?

What are the conservative treatment options for hidradenitis suppurativa (HS)?

Which medications are used in the management of hidradenitis suppurativa (HS)?

What are the surgical options for hidradenitis suppurativa (HS)?

When is radiotherapy indicated for hidradenitis suppurativa (HS)?

What is hidradenitis suppurativa (HS)?

What is the historical understanding of hidradenitis suppurativa (HS)?

What is the pathophysiology of hidradenitis suppurativa (HS)?

What is the etiology of hidradenitis suppurativa (HS)?

What is the historic theory of hidradenitis suppurativa (HS)?

What type of disorder is hidradenitis suppurativa (HS)?

What inflammatory changes occur in the initial stages of hidradenitis suppurativa (HS)?

What is the role of bacterial infection in the etiology of hidradenitis suppurativa (HS)?

Which bacteria have been isolated in hidradenitis suppurativa (HS)?

What is the initial inflammatory event in the pathogenesis of hidradenitis suppurativa (HS)?

What causes hidradenitis suppurativa (HS)?

What is the role of genetic factors in the etiology of hidradenitis suppurativa (HS)?

What is the role of gamma-secretase in the etiology of hidradenitis suppurativa (HS)?

How prevalent are genetic factors in the etiology of hidradenitis suppurativa (HS)?

What is the role of neutrophils in the pathogenesis of hidradenitis suppurativa (HS)?

What is the role of natural killer cells in the pathogenesis of hidradenitis suppurativa (HS)?

What is the role of toll-like receptors in the pathophysiology of hidradenitis suppurativa (HS)?

What is the role of androgens in the pathogenies of hidradenitis suppurativa (HS)?

What role does estrogen have in the pathophysiology of hidradenitis suppurativa (HS)?

What evidence supports the theory of an androgen etiology of hidradenitis suppurativa (HS)?

Which common findings in women with hidradenitis suppurativa (HS) may be due to hormonal effects?

What is the role of circulating androgens in the etiology of hidradenitis suppurativa (HS)?

What is the role of cigarette smoking in the etiology of hidradenitis suppurativa (HS)?

What is the role of chemical and mechanical irritation in the etiology of hidradenitis suppurativa (HS)?

Which medications may cause hidradenitis suppurativa (HS)?

How is hidradenitis suppurativa (HS) associated with lung and buccal cancer?

Which type of cancer may be a complication of hidradenitis suppurativa (HS)?

Which factors increase the risk of hidradenitis suppurativa (HS)?

What is the prevalence of hidradenitis suppurativa in the US?

What is the global prevalence of hidradenitis suppurativa (HS)?

How does the prevalence of hidradenitis suppurativa (HS) vary among races?

How does the prevalence of hidradenitis suppurativa (HS) vary between men and women?

How does the incidence of hidradenitis suppurativa (HS) vary among age groups?

What is the disease progression of hidradenitis suppurativa (HS)?

What are the adverse socioeconomic effects of hidradenitis suppurativa (HS)?

What is the prognosis of hidradenitis suppurativa (HS)?

How effective is surgical intervention for hidradenitis suppurativa (HS)?

Which factors influence the prognosis of hidradenitis suppurativa (HS)?

What are the recurrence rates for hidradenitis suppurativa (HS) treated with radical surgery?

Which factors increase the postoperative relapse risk in hidradenitis suppurativa (HS)?

What is the prognosis of untreated hidradenitis suppurativa (HS)?

What education should be provided to patients with hidradenitis suppurativa (HS)?

Presentation

Which history is characteristic of hidradenitis suppurativa (HS)?

How is hidradenitis suppurativa (HS) diagnosed?

What are the primary diagnostic criteria for hidradenitis suppurativa (HS)?

What are the secondary diagnostic criteria for hidradenitis suppurativa (HS)?

Which physical findings suggest hidradenitis suppurativa (HS)?

How are active and inactive disease distinguished in hidradenitis suppurativa (HS)?

Which questions may form the basis for diagnosis of hidradenitis suppurativa (HS)?

What areas of the body are commonly affected by hidradenitis suppurativa (HS)?

How do abscesses form in hidradenitis suppurativa (HS)?

How is a draining sinus tract characterized in hidradenitis suppurativa (HS)?

What is the hallmark finding of hidradenitis suppurativa (HS)?

What does inguinal-anogenital infiltration involve in hidradenitis suppurativa (HS)?

What are signs of perianal hidradenitis suppurativa (HS)?

What are the treatment implications of comorbid hidradenitis suppurativa (HS) and Crohn disease?

Which disorders with prominent poral occlusion are associated with hidradenitis suppurativa (HS)?

Which physical findings suggest comorbid hidradenitis suppurativa (HS) and HIV-associated follicular syndrome?

Which physical findings suggest comorbid hidradenitis suppurativa (HS) and arthritis?

What is the presentation of arthropathy associated with hidradenitis suppurativa (HS)?

How is SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis) differentiated from hidradenitis suppurativa (HS)?

What are physical findings of comorbid pyoderma gangrenosum and hidradenitis suppurativa (HS)?

What are the possible complications of hidradenitis suppurativa (HS)?

What are possible complications of axillary hidradenitis suppurativa (HS)?

What are possible complications of perianal hidradenitis suppurativa (HS)?

What are possible complications of hidradenitis suppurativa (HS) after streptococcal infection?

What are possible complications in male patients with hidradenitis suppurativa (HS)?

What are rare complications of hidradenitis suppurativa (HS)?

What is the incidence of cancer in hidradenitis suppurativa (HS)?

What is the prevalence of squamous cell carcinoma (SCC) in hidradenitis suppurativa (HS)?

What is a late complication of hidradenitis suppurativa (HS)?

DDX

What are the differential diagnoses for Hidradenitis Suppurativa?

Workup

Which lab studies are indicated in the evaluation of hidradenitis suppurativa (HS)?

Which lab findings are characteristic of hidradenitis suppurativa (HS) with acute lesions?

Which ultrasonography findings suggest hidradenitis suppurativa (HS)?

What is the role of bacteriologic analysis in the workup of hidradenitis suppurativa (HS)?

What immunohistochemical findings are characteristic of hidradenitis suppurativa (HS)?

What is the role of cytokeratins (CKs) testing in the workup of hidradenitis suppurativa (HS)?

What is the CK expression in hidradenitis suppurativa (HS)?

What are the histologic findings of hidradenitis suppurativa (HS)?

What is the earliest inflammatory event in hidradenitis suppurativa (HS)?

How is the inflammatory infiltrate characterized in hidradenitis suppurativa (HS)?

What are the histologic findings of chronic lesions in hidradenitis suppurativa (HS)?

What are the histologic findings of a draining sinus tract in hidradenitis suppurativa (HS)?

What are the histologic findings of lipid rafts in hidradenitis suppurativa (HS)?

What are the histologic findings of keratinocytes in hidradenitis suppurativa (HS)?

How are histologic findings of squamous cell carcinoma (SCC) and hidradenitis suppurativa (HS) distinguished?

What is the physician global assessment (PGA) for hidradenitis suppurativa (HS)?

What is the Hurley clinical staging of hidradenitis suppurativa (HS)?

What is the dynamic staging system of hidradenitis suppurativa (HS)?

Which staging system is recommended for treatment monitoring in hidradenitis suppurativa (HS)?

Treatment

What are the treatment goals for hidradenitis suppurativa (HS)?

What are the treatment options for hidradenitis suppurativa (HS)?

How effective are treatments for hidradenitis suppurativa (HS)?

When is surgery indicated in the treatment of hidradenitis suppurativa (HS)?

When is electrosurgery indicated in the treatment of hidradenitis suppurativa (HS)?

What is the role of nonsurgical procedures in the treatment of hidradenitis suppurativa (HS)?

What is the role of radical surgery in the treatment of hidradenitis suppurativa (HS)?

Which surgical techniques are used in the treatment of hidradenitis suppurativa (HS)?

Which procedures are indicated for treatment of the acute phase of hidradenitis suppurativa (HS)?

What are the treatment options for chronic and extensive hidradenitis suppurativa (HS)?

Which minor procedures are performed in the treatment of hidradenitis suppurativa (HS)?

How is surgical excision performed for hidradenitis suppurativa (HS)?

What is the goal of surgery for hidradenitis suppurativa (HS)?

How effective is Nd:YAG laser treatment for hidradenitis suppurativa (HS)?

What are the methods for reconstruction after surgery for hidradenitis suppurativa (HS)?

What is the role of skin grafting in the management of hidradenitis suppurativa (HS)?

Which factor influences the therapeutic outcome of hidradenitis suppurativa (HS) surgery?

What is the role of radiation therapy in the treatment of hidradenitis suppurativa (HS)?

Are dietary restrictions indicated in hidradenitis suppurativa (HS)?

Which lifestyle modifications are useful in the treatment of hidradenitis suppurativa (HS)?

Guidelines

What are the HSF treatment guidelines for hidradenitis suppurativa (HS)?

What are the EDF treatment guidelines for hidradenitis suppurativa (HS)?

What clinical trials have been conducted on the medication therapies for hidradenitis suppurativa (HS) treatment?

How was the treatment algorithm for hidradenitis suppurativa (HS) treatment developed?

How should the need for surgical intervention in hidradenitis suppurativa (HS) be assessed?

What is the initial dosing regimen for the treatment of mild hidradenitis suppurativa (HS)?

When is adalimumab indicated in the treatment of hidradenitis suppurativa (HS)?

When is second- or third- line therapy indicated in the treatment of hidradenitis suppurativa (HS)?

What are the second-line therapies for hidradenitis suppurativa (HS)?

When is alternative therapy indicated if second-line treatment of hidradenitis suppurativa (HS) has failed?

What are third-line therapies for hidradenitis suppurativa (HS)?

Medications

How is hidradenitis suppurativa (HS) treated?

What is the treatment algorithm for hidradenitis suppurativa (HS)?

Which topical medications are effective in the treatment of hidradenitis suppurativa (HS)?

When is systemic treatment indicated in hidradenitis suppurativa (HS)?

Is hyperbaric oxygen therapy an effective treatment for hidradenitis suppurativa (HS)?

Which combination therapies are recommended for the treatment of hidradenitis suppurativa (HS)?

What is the role of dapsone therapy for hidradenitis suppurativa (HS)?

What is the role of retinoids in the treatment of hidradenitis suppurativa (HS)?

What is the role of isotretinoin in the treatment of hidradenitis suppurativa (HS)?

How often should pregnancy testing be done during hidradenitis suppurativa (HS) treatment?

How are draining sinuses treated in hidradenitis suppurativa (HS)?

What is the role of corticosteroids in the treatment of hidradenitis suppurativa (HS)?

What is the efficacy of infliximab treatment for hidradenitis suppurativa (HS)?

What are the adverse effects of infliximab in the treatment of hidradenitis suppurativa (HS)?

How effective are TNF-alpha inhibitors in the treatment of hidradenitis suppurativa (HS)?

Which biologic drugs are most effective in the treatment of hidradenitis suppurativa (HS)?

What is the role of immunosuppression therapy in the treatment of hidradenitis suppurativa (HS)?

What is the role of finasteride in the treatment of hidradenitis suppurativa (HS)?

What are the treatments for pain in hidradenitis suppurativa (HS)?

What is the role of NSAIDs in the treatment of hidradenitis suppurativa (HS)?

What is the role of opioids in management of hidradenitis suppurativa (HS)?

What is the first line-therapy for neuropathic pain in hidradenitis suppurativa (HS)?

What is the role of exfoliants in the treatment of hidradenitis suppurativa (HS)?

What other therapies may be beneficial in the treatment of hidradenitis suppurativa (HS)?

Which medications in the drug class Trace Elements/Metals are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class 5-Alpha-Reductase Inhibitors are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class Estrogen Derivatives are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class Immunosuppressants are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class Antiandrogens are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class Corticosteroids are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class Retinoids are used in the treatment of Hidradenitis Suppurativa?

Which medications in the drug class Antibiotics, Other are used in the treatment of Hidradenitis Suppurativa?