Hidradenitis suppurativa

Hidradenitis suppurativa, or Verneuil's disease, is somewhat common, especially in women, but it often unrecognized. Clinical manifestations include painful nodules, abscesses, sinus tracts, and ropelike hypertrophic scars in the apocrine gland-bearing areas. It is a chronic disease. Smoking and overweight are risk factors, but the cause is unknown: it is a disease of the follicular apparatus, neither infectious nor hormonal. Severe dramatic forms are rare. Quality of life is severely affected even in the mild forms. Treatment is both medical and surgical: wide-spectrum antibiotics and excisions tailored to the extent of involvement. Anti-TNF alpha drugs are effective, but their risk-benefit ratio is still in question. Laser treatment is under study.