Hidradenitis suppurativa (HS) is a chronic, painful, inflammatory skin disorder. It is characterized by the development of inflammatory nodules, pustules, sinus tracts, and scars in intertriginous areas.

It should be suspected in pubertal or post-pubertal patients who have a diagnosis of recurrent furuncles or boils, especially in intertriginous areas.

Epidemiology:

• Women are more likely to develop HS than men.
• It most commonly affects adults under 40.

Pathogenesis:

• Chronic inflammatory occlusion of folliculopilosebaceous units that obstructs the apocrine glands and prevents keratinocytes from properly shedding from the follicular epithelium.

Risk factors:

• Family history
• Smoking
• Obesity, diabetes, polycystic ovarian syndrome
• Mechanical stretching of skin

PC:

• Initial manifestation involves recurrent, painful, and inflamed nodules.
• HS occurs most commonly on intertriginous skin. However, non-intertriginous skin involvement also can occur. The axilla is the most common site
• Other areas include inguinal, inner thighs, perineal and perianal, inframammary skin.