JAMA DERMATOLOGY PATIENT PAGE

Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) is an inflammatory disorder of hair follicles,
most commonly in the armpits, groin,
Hidradenitis suppurativa (HS)
under the breasts, and in between the buttocks.
Common locations Appearance
Depending on the stage of the disease, it may present with painful,
tender papules (bumps on the skin), cysts, or nodules (larger lumps
under the skin), and scarred down areas. Smelly pus may drain from
the skin, and sometimes large tracts of pus form under the skin (called
sinus tracts). The cause of HS is still unknown, but important strides
have been made in better understanding the disease.
Mild HS
The Facts of HS
HS can occur in people of all ethnicities and all ages, but it may be more
common in women, African Americans, and young adults. It has been Armpit
associated with obesity and tobacco use, and patients are encouraged
to lose weight and quit smoking. It may occur with other disorders of
the hair follicle such as acne conglobata (a severe form of acne), pilo-
nidalcysts(usuallyoccuronthelowerbackandbuttocksarea),anddis-
secting cellulitis (severe hair loss with scarring of the scalp). There may
Moderate HS
alsobeanassociationwithinflammatoryboweldisease.HSsignificantly
affectspatients’lives.PatientswithHShavebeenshowntohavehigher Under the breasts
rates of depression than those without the disorder.

Diagnosis and Testing

Biopsies, infectious cultures, and laboratory tests are of limited use
in HS. The diagnosis is usually made by a dermatologist, who takes
into account how long the disease has been present, the types of
Groin
skin findings, and the location of these skin findings. While HS may Severe HS
Between
occur more commonly if a family member is affected, it often oc- the buttocks
curs in people without any known family history of the disorder.

Treatment
There is no cure for HS, but many treatments are available based on
the stage of the disease. For mild to moderate disease, treatment
options include antibiotic creams and lotions, antibiotic washes, oral
antibiotics, local steroid injections, small surgical procedures, laser
treatments, and pills that regulate hormones. For more severe dis-
ease, these treatments may still be helpful, as well as injectable bio-
logic agents, larger surgical procedures, immunosuppressive pills
(medications that suppress the immune system), and other oral
medications. Patients are encouraged to quit smoking, maintain a
healthy weight, and wear looser-fitting clothing.
FOR MORE INFORMATION
• Hidradenitis Suppurativa Foundation
http://www.hs-foundation.org/
• American Academy of Dermatology
https://www.aad.org/dermatology-a-to-z/diseases
-and-treatments/e---h/hidradenitis-suppurativa
• National Organization for Rare Disorders
https://rarediseases.org/rare-diseases/hidradenitis-suppurativa/
To find this and other JAMA Dermatology Patient Pages, go to the
Patient Page link on the JAMA Dermatology website at
http://www.jamaderm.com.

Author: Ali Alikhan, MD The JAMA Dermatology Patient Page is a public service of JAMA Dermatology. The
Conflict of Interest Disclosures: None reported. information and recommendations appearing on this page are appropriate in most
instances, but they are not a substitute for medical diagnosis. For specific information
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