Hidradenitis Suppurativa Increases Risk For Alopecia
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In a study investigating the relationship between hidradenitis suppurativa and alopecia areata in a U.S. sample, those with hidradenitis suppurativa had a significantly higher risk for alopecia of any type and also lichen planopilaris.
Both and likely involve an inciting event at the hair follicle, which leads to subsequent inflammation,Joslyn S. Kirby, MD, MS, MEd, of the department of dermatology at Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania, and colleagues, wrote.
The hidradenitis suppurativa group comprised patients aged at least 12 years with two separate HS-related claims in an 18-month period. The age- and sex-matched control group included randomly selecting individuals at a ratio of 10 controls to every one patient in the HS group. Controls were never diagnosed with HS, pilonidal cyst, acne conglobata or dissecting cellulitis of the scalp during the same period.
The researchers identified 36,450 matched controls and 3,645 patients with HS.
The HS group had a significantly higher risk for any alopecia areata , including alopecia totalis or universalis , when compared with the control group. Researchers also discovered an increased risk for lichen planopilaris in patients with HS.
Disclosures: The authors report no relevant financial disclosures.
What Complications Can Be Of Hidradenitis Suppurativa
- The affected area can get infected.
- Boils or abscess heals very slowly which leaves scars and marks behind.
- When the abscess is in armpits or thighs it can cause soreness and restrict the movement of the part.
- Obstruction of the lymph node is very common in this disease which can cause swelling of the legs, arms or genitals.
- Due to the restriction of movements and bad odor from the boils can be the point embarrassment for the patient which can cause social isolation.
- In rare cases patient with this disease can develop squamous cell carcinoma of the affected area.
How Does A Board
While HS can look like acne, boils and other skin diseases, the trained eye of a board-certified dermatologist can distinguish among these conditions. To diagnose HS, the dermatologist will look at your skin and ask specific questions. If your HS sores are leaking fluid, the doctor may swab some of this fluid to see if there is an infection.
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Weight Loss Surgery For Hs
Some people with HS may consider weight loss surgery as a way to help them achieve a more moderate weight and improve their symptoms.
A case study of a woman with HS and obesity describes improvements to her HS symptoms within 3 months of having a laparoscopic gastric sleeve procedure. After this time, the discharge and foul odor disappeared from her lesions, and no new lesions formed. A year later, she had significant weight loss and symptom reduction.
However, while some people may see their HS symptoms lessen as a result of weight loss surgery, researchers caution that these surgeries do carry risks relating to HS.
For instance, weight loss surgery is not a guarantee that HS symptoms will decrease. A survey of online forum posts showed that only 29% of people with HS who had undergone weight loss surgery saw an improvement in symptoms. Of the survey participants, 39% reported no change in symptoms. Others reported that weight loss surgery even made their symptoms worse.
Rapid weight loss, which is common after weight loss surgery, can cause excess loose skin. The excess skin can lead to an increase in skin folds and, therefore, areas of friction, which can increase HS symptoms.
Weight loss can be challenging for anyone. If a person with HS is finding it difficult to lose weight, and diet and exercise changes are proving ineffective, weight loss surgery may be an option.
Do I Need Any Tests To Diagnose Hidradenitis Suppurativa
There are no tests used to diagnose hidradenitis suppurativa. The diagnosis is usually based on the typical signs and symptoms that a person may have.
Sometimes hidradenitis suppurativa is confused with other similar-looking skin conditions such as common boils, collections of pus , skin infections and ingrowing hairs. Other diseases can cause tunnels known as sinus tracts – for example, Crohn’s disease. Tests might be needed to exclude these other conditions, although they often have many other symptoms.
Sometimes, if there are signs of infection, small samples can be taken. This is to see what germs are growing in the pus. This can help in deciding whether antibiotic medicines should be used.
Occasionally, it might be helpful to test your blood for sugar to make sure you do not have diabetes. This is because skin infections are more common in people with diabetes. Your doctor might also take blood tests to make sure you are not anaemic and to monitor the level of infection or inflammation.
Scans, such as CT scans, are not needed to diagnose the condition. They may, however, be used in very severe disease, to plan surgery, as it is important to know where the sinus tracts go and how deep they are.
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How Do Health Care Professionals Diagnose Hidradenitis Suppurativa
- A patient with recurrent abscesses in the armpit, groin, or buttocks may well have HS.
- The condition may vary from mild to quite severe cases.
- Infections produced by bacteria or fungi need to be excluded because they often are quite curable with antibiotics, whereas HS is not. Doctors may check patients for immune deficiency diseases.
What Is Hidradenitis Suppurativa
The bumps can get infected. When that happens, pockets form under your skin and fill with pus. They can smell bad when they break open. They can also leave scars.
There’s no cure for HS, but treatments and lifestyle changes can bring some relief and cut down on flare-ups.
Because this condition lasts a long time, it can be frustrating, and it can take an emotional toll on you. Make sure you get the support you need.
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Hidradenitis Suppurativa And Hair Loss
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How Will Hidradenitis Suppurativa Be Diagnosed
The diagnosis is usually made by a doctor examining the area, and the history and symptoms described by the patient. There is no specific test on which the diagnosis can be made.The condition is often misdiagnosed initially as an infection or inflammation of the hair follicles which can result in delayed treatment and progression of the disease with scarring.
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Hidradenitis Suppurativa Risk Factors
Some risk factors for Hidradenitis Suppurativa include:
- Age, which generally occurs during puberty, is around the age of 20 to 29 years.
- Genetics, which is experienced if it has a history of this disease in the family, but is not associated with poor hygiene.
- Gender, i.e. Women are more likely to develop this disease than men.
- Smo**king habit.
- Crohns disease.
How Can I Manage My Hs Symptoms
Dermatologists recommend the following tips for easing the symptoms of HS:
- Lose weight if you are
- Do not smoke if you are currently a smoker, take steps to
- Do not shave where HS
- Wear loose-fitting
- Avoid overheating and
A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about HS or to find a board-certified dermatologist in your area, visit aad.org/HS or call toll-free 462-DERM .
Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides
American Academy of Dermatology
P.O. Box 1968, Des Plaines, Illinois 60017AAD Public Information Center: 888.462.DERM AAD Member Resource Center: 866.503.SKIN Outside the United States: 847.240.1280
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Who Develops Hidradenitis Suppurativa
Around 1 in every 100 people in Europe have hidradenitis suppurativa, meaning it is quite common. Many people will have very mild problems with it.
Hidradenitis suppurativa usually affects people between puberty and middle age. It is three times more common in women than in men. It is rare in Asian people and far more common in white-skinned people or Afro-Caribbean people.
Hidradenitis suppurativa only develops after puberty. This is because the sweat glands are activated by hormones called sex hormones, the levels of which increase during puberty. The problem tends to improve for women if they take the combined oral contraceptive pill , or if they are pregnant. It rarely occurs after the menopause. These things all suggest that hormones play a part in causing this disease.
The disease can run in families but the exact pattern of inheritance is not known.
Hidradenitis suppurativa is more common in overweight or obese people and in cigarette smokers. Obesity and smoking are not direct causes. However, they can be thought of as risk factors. Hidradenitis suppurativa also seems more common in people with acne and possibly in women with polycystic ovary syndrome.
Hidradenitis Suppurativa: How To Cope When Depression Hits
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Everyone feels sad or blue at some point in their life. If feelings of sadness, hopelessness, or apathy last for two weeks or longer, you may have depression.
Studies reveal that depression is common in people who have hidradenitis suppurativa . The pain, inflammation, and emotional stress of having this disease all seem to play a role in causing depression.
Several studies confirm that people who live with chronic pain often have depression. Pain is a common symptom of HS. The lumps that develop beneath the skin are often painful. Without proper treatment for HS, the painful lumps grow, burst open, and return. When this cycle continues for a long time, you develop a condition called chronic pain.
Because HS primarily develops in the underarms, groin area, around the anus, and beneath the breasts, it can take an emotional toll. Having painful lumps in these areas can feel embarrassing. When these lumps break open and leak foul-smelling liquid onto clothing, many people say they feel ashamed.
Fortunately, you dont have to live with depression. Its a treatable medical condition.
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What Are The Symptoms Of Hidradenitis Suppurativa
When it first develops, hidradenitis suppurativa can have symptoms that range from mild itching and discomfort to the appearance of a red, tender, and swollen areas. Pimple- and/or boil-like bumps appear and can grow, fill with pus, and then break open. The pus that drains sometimes has a foul odor due to the presence of bacteria. Healing of the bumps can cause scarring. Symptoms vary from person to person.
In some patients, the breakouts can reoccur in the exact spot in others, breakouts occur in the same area but not in the exact same spot. Some people have constant breakouts on their skin in others, scars are the only sign present at that point in time.
Polycystic Ovarian Syndrome :
PCOS is a condition in which a womans hormones are out of balance.4 Women with HS may have PCOS more frequently than in the general population.
In one study, 38% of women with HS had polycystic ovarian syndrome. The inflammatory skin disease needs to be considered in women who show signs of having PCOS, including irregular period and hirsutism .5
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What Are The Causes Of Hidradenitis Suppurativa
The exact cause of Hidradenitis suppurativa is not recognized. But there are some potential reasons which can prone a person to this disease.
- Smoking and obesity both are associated with this disease as it can make symptoms of the disease worse.
- There can be considered the role of sex hormone as this disease usually occur at puberty and is less common after menopause.
- Hidradenitis runs in family so there is a role of genetic factors.
- Environmental factors also play a role in the occurrence of this disease.
What Causes And Risk Factors Of Hidradenitis Suppurativa
Although as many as 40% of patients with HS have a family history of this condition, the precise genetic defect is poorly understood. Health researchers have found a defect in the gamma-secretase Notch signaling pathway in a few patients, but this basic cell regulatory pathway appears mutated only in a minority of those with HS. Patients with HS tend to be obese and frequently smoke. There is microscopic evidence that inflammation in the hair follicles is the seat of the problem and not the apocrine sweat glands as was originally believed. Ultimately, the precise cause is unknown.
The risk factors for hidradenitis suppurativa are:
Symptoms and signs of hidradenitis suppurativa include:
- Patients with the skin condition develop recurrent boil-like lesions in their armpits and groin that appear as painful, small lumps.
- The bumps or sores may begin to leak and drain pus.
- There are blackheads in areas of affected skin.
- Individual lesions may join to produce long draining sinus tracts or tunnels that are tender and continually produce foul-smelling pus drainage.
- When healing occurs, it often leaves multiple areas of unsightly scarring.
- Less commonly, lesions can involve the lower abdomen and the tissues under the breasts.
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