HIDRADENITIS SUPPURATIVA

(Inflammatory lesions, cysts – sores in the armpits, perianal area, buttocks, below the breasts)
By Dr. Nektarios Logaras – Dermatologist/Venereologist

What is Hidradenitis Suppurativa?

-Hidradenitis Suppurativa is a chronic, recurrent inflammatory, malignant skin disease that is characterized by the appearance of painful nodules, abscesses, and deformed scars.
-It mainly affects women and occurs in the ages of 20-30.
-It is located mainly in areas rich in responsive sweat glands, armpits, around the breasts, around the anus (perineum), genitals, femoral areas, groin, buttocks, in the upper and inner surface of thighs, neck and back.
-The armpits are more affected than other areas
-The hidradenitis suppurativa is due to the obstruction of the hair follicles of the skin.
-An underlying immune disorder may be involved in the pathogenesis of the disease.

The incidence of the disease in the general population worldwide is 1% with women being affected 3 times more often than men.

What are the main causes of Hidradenitis Suppurativa?

Recent studies show that hyperkeratosis of the terminal hair follicles is the beginning and essentially the cause of the pathogenetic process that leads to obstruction of the responsive sweat glands, rupture of the hair follicle, inflammation and possible secondary infection.

Genetic factors
The way of inheritance is unclear. The disease is polygenic. Sporadic cases show defects in important genes associated with the pathogenesis of the disease.A type can be transferred with an autosomal dominant character.
Hormones – Androgens. The predominance of women, the onset of the disease after adolescence and its exacerbation before menstruation as well as childbirth led to the conclusion that the disease is androgen-related, something that was not confirmed by blood laboratory tests.

Bacteria
The bacterial involvement is secondary. Routine cultures are often negative, but there are cases where multiple bacteria are isolated, such as staphylococci, streptococci, anaerobes and gram-negative microbes (Proteas, Escherichia coli and Klebsiella). The upper germs are colonizers of the lesions and are not considered as causative agents.

Immunological factors
Recent studies suggest that an underlying immune disorder may be involved in the pathogenesis of the disease.

Risk factors
Studies by Revuz and his colleagues have shown that smoking and obesity are not the primary causative agents of the disease but are related to it and may worsen it.

Clinical picture

The disease has a varied course and severity.
-The diagnosis is made based on clinical characteristics and based on criteria adopted by the 21st International Conference on Hidradenitis Suppurativa in 2009 in San Francisco.
-Lesions are divided into primary and secondary.

Staging

-Stage 1. Mild disease. Inflammatory nodules and abscesses without scars.
-Stage 2. Moderate disease. One or multiple inflammatory nodules – abscesses + scars with healthy skin between them.
-Stage 3. Severe disease. Diffuse or almost diffuse infection, abscesses that communicate with each other, scars.

Treatment

General measures include:

-Stop smoking
-Weight loss
-Personal hygiene
-Wide, comfortable clothes
-Psychological support

Medications are local and systemic, and are individualized according to the incidence and severity of the disease.

Surgical treatment

The resection of all the affected skin, beyond the clinically affected limits, is considered an effective treatment for severe relapse cases.

The Doctor’s experience

Dr. N. Logaras MD
Dermatologist Venereologist
Laser Dermatologic Surgeon

Graduate of Nottingham and Birmingham Universities of England

-Specialization in Dermatologic Surgery, Department of Plastic Surgery, Hospital of Dermatology & Venereal Diseases “Andreas Syggros”
-Specialization in Digital Dermoscopy – Mole Mapping, at the Department of Dermoscopy and Melanoma, Hospital of Dermatology & Venereal Diseases “Andreas Syggros”
-Degree in Medicine, Bachelor of Medicine and Bachelor of Surgery, The University of Nottingham, UK.

CAREER AND PROFESSIONAL EXPERIENCE

-Dermatologist – Venereologist, Private Clinic – Athens South Dermatology & Laser Center, Alimos
-Dermatology – Venereology Specialty, Hospital of Dermatologic & Venereal Diseases “Andreas Syggros”
-Former Doctor, Royal Derby | Derby Teaching Hospitals NHS Foundation Trust, England
-Former Doctor, Taunton and Somerset Hospital NHS Trust-Musgrove Park, England
-Former Doctor, Worthing and Southlands Hospitals NHS Trust, England
-Former Doctor, Queen Alexandra Hospital, England
-Former Doctor, Portsmouth Hospital NHS Trust, England
-Former Doctor, Brighton and Sussex University Hospitals NHS Trust, England

19 years of medical experience

Phone No. for Appointment: +302109821431