Acne Inversa
Hidradenitis Suppurativa (Acne Inversa): The Painful Skin Condition
Hidradenitis suppurativa, also known as acne inversa, manifests as painful lumps forming under the skin. These lumps typically emerge in areas of skin friction, such as the armpits, groin, buttocks, and breasts. Slow to heal and prone to recurrence, they can result in tunneling under the skin and scarring.
Symptoms
- Blackheads: Small, pitted areas of skin often exhibiting pairs of blackheads.
- Painful Pea-sized Lumps: Typically starting as a single painful lump persisting for weeks or months, with more bumps developing later.
- Leaking Bumps or Sores: Some lesions enlarge, rupture, and emit pus with an odor.
- Tunnels: Progression may lead to tunnel formation under the skin, connecting the lumps and resulting in slow or absent wound healing with blood and pus discharge.
Who's at Risk
- Onset: Usually post-puberty and before age 40.
- Gender Disparity: Women are three times more susceptible, with variation across regions, and higher prevalence among Black individuals, suggesting genetic involvement.
Seeking Medical Attention
Early diagnosis is crucial for effective management. Consult a dermatologist if symptoms:
- Are painful or impede movement.
- Persist or recur despite treatment.
- Present in multiple locations or flare frequently.
Treatment and Care
Hidradenitis suppurativa requires a comprehensive approach combining medical and surgical interventions to manage symptoms and prevent complications. A multidisciplinary healthcare team, primarily comprising dermatologists, ensures optimal care.
Causes and Risk Factors
While the exact cause remains elusive, factors like hormones, genetics, smoking, and obesity may contribute. Importantly, the condition isn't contagious and isn't caused by infections or poor hygiene.
Complications
- Infections: Secondary infections are possible but not definitive.
- Scarring and Limited Mobility: Wounds may heal leaving scars, restricting movement, especially in areas like the armpits and thighs.
- Skin Cancer Risk: Long-term cases may elevate the risk of squamous cell carcinoma, particularly in the perianal area.
- Lymphatic System Impairment: Scar tissue may obstruct lymph drainage, resulting in swelling in limbs or genitals.
- Psychological Impact: Embarrassment due to location, odor, and drainage may lead to social withdrawal and psychological distress.
- Chronic Pain: Exacerbated pain compared to other skin conditions like psoriasis, impacting quality of life significantly.
