Acne inversa is a chronic, painful, and inflammatory skin disease that affects a young and active population. The disease involves painful, deep abscesses and chronic, draining sinus tracts. Acne inversa is also called hidradenitis suppurativa, or “HS for short, and it can often be misdiagnosed by doctors who are not familiar with the disease. Acne inversa is sometimes mistakenly thought of as an orphan disease. While it is not an orphan disease in terms of its prevalence, it often is a lower priority in comparison to other dermatological conditions in terms of notice, interest, and developing research. A dermatologist will be able to identify the condition quicker than other providers simply because we are familiar with it and know what signs and symptoms to look for. Unfortunately, for most people who have HS, on average, they will see five doctors before they see a dermatologist that identifies the disease. Among dermatologists AI/HS is considered a prototypical skin disease. This is because once you are aware of the disease it is most often easy to see and easy to feel.
Acne inversa takes not only a physical toll on patients, but emotional and social ones as well. Patients with this disease have been shown to suffer higher levels of mental health difficulties, in particular depressive symptoms, even when compared to patients with other skin diseases.
Signs and symptoms of acne inversa are very apparent, which is why patients who have it may struggle socially and emotionally with the condition. The lesions itch, are painful, suppurate (which means the sores have discharge or pus), and scar, disfiguring the skin. Patients most often describe the sores as “boils”. This is an interesting description because it is often associated with uncleanliness, which is a mythical factor in HS. Patients who have the disease are made to feel that it is the result of poor hygiene, and this is not at all true. Hidradenitis is not a disease associated with hygiene. Another symptom that is the most obvious hallmark of the disease is the restriction to the skin areas affected. The disease is essentially limited to areas of skin where there is a high concentration of hair follicles and apocrine glands (i.e the underarm, groin, buttocks, nape of neck and scalp, and mammary glands). While the disease originates in follicles it is not a disease triggered by infection.
Facts regarding Acne Inversa/Hidradenitis Suppurativa:
- Patients with HS face a host of comorbidities – depression, metabolic syndrome, auto-immune disorders, endocrine disorders, etc.
- 200,000 cases occur in the United States each year
- While HS may look like bad acne, the disease occurs in places you would not expect acne (underarm, groin, breasts, anus, etc.).
- Causes serious scars.
- Women are three times more likely to develop the disease than men.
- Women are most likely to get them on the genitals and around the anus.
- The cause of the disease is not known.
- 1/3 of patients with the disease have a relative who also has the disease.
- Diagnosis can be simple if seen by a dermatologist.
- Smoking can significantly increase the severity of the flare-ups.
- Losing ~10% of body weight has shown to reduce the risk of flare ups.
- Wearing looser-fitting clothes can prevent irritation.
- Overweight or obese people are at greater risk of experiencing flare-ups.
- The disease is not contagious.
- Individuals of African and Hispanic decent have a higher prevalence of the disease than other ethnic groups.
- Humira, a treatment that is primarily used for patients with psoriasis, has shown tremendous results when treating patients with hidradenitis suppurativa.
Data shows that there is a large prevalence of hidradenitis suppurativa in the Pine Belt and surrounding areas. As stated above, the causes of the disease are unknown, but there are many treatment options available as long as you are able to get a proper diagnosis. My colleagues and I have extensive experience treating hidradenitis suppurativa. If you suspect you or a loved one may have this painful disease, do not hesitate to come to one of our offices. We also have a HIPAA secure mobile app that will allow one of us to see you virtually. Regardless of what skin condition you have, myself or one of the other providers can help you achieve healthy skin.
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