HIDRADENITIS SUPPURATIVA |
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DESCRIPTIONHidradenitis suppurativa is a skin disorder characterized by nodules in the armpit. It appears rarely on the buttocks or groin or under the breasts. It is most common in females 13 to 15 years old, but it can occur in both sexes.
Appropriate health care includes:
Self-care after diagnosis.
Doctor's treatment.
Surgery to open and drain abscesses or to remove involved skin (severe cases only).
SIGNS & SYMPTOMS
Nodules with the following characteristics:
Nodules are firm, tender, and domed.
Nodules are 1cm to 3cm in diameter.
Larger nodules soften in the center and become painful. When pressed, they feel like an overfilled inner tube.
Nodules open and drain pus spontaneously.
Individual nodules (with or without drainage) heal slowly over 10 to 30 days.
Nodules leave scars.
Severity of the disorder varies from a few lesions per year to a constant succession of lesions that form as old ones heal. Lesions frequently recur at the same site.
CAUSES
Hormonal influences that activate the apocrine glands under the arms. Secretions in these glands enlarge the gland. The outlets become blocked, probably by heat, sweat, or incomplete gland development. The secretions that are dammed in the glands force sweat and bacteria into surrounding tissue, which becomes infected.
RISK FACTORS
Obesity.
Exposure to environmental heat and moisture.
Genetic factors. This disorder is most common in black females.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory culture of the discharge from the child's draining abscess.
POSSIBLE COMPLICATIONSScarring.
PROBABLE OUTCOME
This disorder may last many years -- from puberty through the following 10 to 20 years. Your child's symptoms can be controlled with treatment.
TREATMENT
HOME CAREInstructions for your child:
Don't use commercial underarm deodorants.
Minimize heat and sweating.
Avoid constrictive clothing and clothing made of synthetic fibers.
Lose weight if you are overweight.
Wash with antibacterial soaps.
Use soaks to relieve itching and hasten healing. Warm-water soaks are usually more soothing for pain or inflammation. Cool-water soaks feel better for itching.
Discontinue underarm shaving.
MEDICATION
Your doctor may do any of the following for your child:
--Inject cortisone drugs directly into the lesions.
--Prescribe antibiotics to fight infection.
--Prescribe hormones to help subdue inflammation.
--Provide instructions for acceptable deodorant protection.
--Prescribe pain medication. For minor discomfort, use non-prescription drugs such as acetaminophen.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Your child should restrict activity in hot weather, and should avoid hot jobs if possible. Swimming is excellent, especially swimming in the ocean.
DIET & FLUIDS
No special diet unless your child needs to lose weight. See Appendix 31 for a reducing diet.
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of hidradenitis suppurativa.
Lesions don't improve after 5 days of treatment.
Your child's temperature rises to 101F (38.3C).
Lesions appear that become soft and seem to have pus, but don't drain spontaneously.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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