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L73.2 – Hidradenitis suppurativa
59393003 – Hidradenitis suppurativa
SynopsisHidradenitis suppurativa is a destructive, chronic inflammatory disorder of the terminal follicular epithelium in apocrine gland-bearing regions. This disease was once thought to be caused by bacterial infection, but it has now become clear that it is a noninfectious acneiform disease. It is believed that follicular occlusion leads to trapping of follicular contents, rupture, and inflammation of the dermis, with bacterial superinfection in some cases. Hidradenitis suppurativa is more common in women and individuals of African descent.
The nodules of hidradenitis suppurativa are seen most commonly on the buttocks, breasts, and in the groin and axillae. Usually, the onset of the disease occurs soon after puberty, and patients typically report recurring "boils." Symptoms may include arthralgias and local pain and tenderness during a flare-up. Shaving, depilation, deodorants, and mechanical irritation can worsen this condition, but irritation of the skin is usually not a major factor. Obesity and cigarette smoking are associated with hidradenitis suppurativa. Hidradenitis suppurativa and metabolic syndrome are strongly associated.
Interestingly, hidradenitis suppurativa shares similar clinical features (severe inflammation, occlusion of the follicle, and scarring) with dissecting cellulitis of the scalp and acne conglobata. Collectively, these 3 conditions are referred to as the follicular occlusion triad, and more than one may occur in a given patient. Some consider the pilonidal sinus (pilonidal cyst) to be an additional member of this group.
With a prevalence of up to 1% in some population-based studies, hidradenitis suppurativa is a common disease.