HIDRAADENITIS SUPURATIVE

DEFINITION A primary disorder of apocrine glands

Synonim : apocrinitis, Hidraadenitis supurative

EPIDEMIOLOGY Age : HS rarely develop before puberty or after menopouse. The Average age of onset 23 years It is more common in females males

ETIOLOGY Unknown Predisposition factor : - Obesity - Hormones and androgen - Bacterial Infection Clinical finding Initial lesion : Abcess/ erythema nodul, producing a purulen discharge, intermitten pain Typical lesion : Open Comedones Advanced lesion : fibrosis, sinus track, skar hipertrofic. Predilection : Axilla, breast area, anogenital region, and inguinal.

Initial Lesion Adnvanced lesion Laboratory test Bacteriologic: S. aureus , streptococci, Escherichia coli, Proteus mirabilis, and Pseudomonas aeruginosa Histopatology : Initial lesion : Folicular occlusion with subsequent inflamation Advanced lesion : adnexal gland involvement, fibrosis and scaring

Differntial diagnosis Abscess (including form methicilin resient, staphylococcus aureus) Furuncles/ carbuncles Actimycosis Cat scartch disease Donovanosis Lymphogranuloma veberum Lymphadenitis Infected bartholin cyst Chron disease Ulcerative colitis Sclofuroderma

Treatment Initial lesion: Nodul: triamcinolone acetonide (35 mg/mL) Abcess : incision & drainage Advantage lesion : Oral Antibiotic (Eritromycin, tetracyclin, minocyclin) Oral Cortikosteroid