Causes of hidradenitis in the groin. Hidradenitis Suppurative hidradenitis in the groin treatment methods

Mechanism of disease development

Basically, the inflammation is one-sided. The process can also manifest itself in the groin (hidradenitis in the groin). Much less frequently, the inflammatory process affects the area around the nipples, as well as in the scrotum, anus, labia majora (hidradenitis on the labia), and in the folds under the mammary glands in women.

Due to the similarity of the abscesses to the mammary glands of dogs, people gave the disease hidradenitis the name “bitch udder.” Many characterize the disease as “red bumps”, “subcutaneous abscesses”, “painful lumps”, etc.

This pathology can manifest itself in all representatives of humanity, but the most severe forms of hidradenitis affect people of the Negroid race.

Causes

Important! A bitch udder in the groin, on the genitals, under the armpit, near the nipples and anus appears most often in adolescence or in the post-pubertal period.

The cause of inflammation of the apocrine glands is most often staphylococci, but Proteus, streptococci and other representatives of microflora unfriendly to humans can become. Provoking factors include:

• serious hormonal disorders or minor changes in the functioning of the endocrine system associated with age, physiological and other characteristics;
• increased sweating;
• metabolic diseases;
• reduced immunity;
• wearing tight and uncomfortable clothes and underwear;
• preference for synthetic fabrics when choosing clothing items;
• failure to comply with hygiene standards.

If you detect one or more dense nodes, you must pay close attention to your health, monitor the development of symptoms and do not hesitate to consult a doctor.

In many cases, the main cause of hidradenitis is infection with staphylococcus. In medical practice, there have also been cases where streptococci were the causative agent of the disease.

In general, the following causes of inflammation of the apocrine glands can be identified:

• neglect of the rules of hygiene of intimate places;
• hormonal imbalances;
• endocrine disorders associated with age-related or physiological changes;
• hyperhidrosis, in which pathogenic microbes multiply in secreted secretions;
• metabolic disorders;
• weakened immunity;
• wearing synthetic and tight underwear and trousers;
• abnormal development of the duct responsible for sweat secretion.
• skin diseases;
• the presence of abrasions, scratches, scratches in the area where there is a risk of disease.

As already mentioned, hidradenitis is an inflammation of the sweat glands, characterized by the appearance under the skin of painful nodes, bulges, indurations and bluish-purple abscesses, mainly in the folds of the skin, more often in the armpits, in the groin area and under the breasts (in women).

This condition is sometimes popularly called bitch udder. The disease is most often encountered by people aged 30-40 years; it practically does not occur in the elderly and children, since the functionality of the sweat glands is not very active.

The main cause of hidradenitis is the development and proliferation of bacteria and microorganisms on vulnerable or inflamed human skin. Most often, the causative agent of infection is Staphylococcus aureus, but representatives of streptococci and Protea can settle. Several factors can provoke inflammation of the sweat gland under the armpit or in the groin, for example:

Excessive sweating may be the cause

As a rule, the causative agent of hidradenitis is Staphylococcus aureus. The infection, passing through the hair follicle, ends up in the excretory duct of the sweat glands. Factors that can trigger the development of hidradenitis include:

According to scientific estimates, about 10% of people with hidradenitis are non-smokers; in the remaining 90% of cases, it is smokers who suffer from this disease.

Classification

According to the nature of the pathological process:

• acute hidradenitis suppurativa;
• chronic hidradenitis.

By location of the lesion:

• bilateral;
• unilateral.

Treatment of the third stage of development of hidradenitis (bitch udder)

When many nodes, lumps, and abscesses appear in the groin, under the arms or under the breasts in women, which are close to each other and occupy a large amount of the body, the doctor speaks of the third stage of the development of hidradenitis.

Treatment of the third stage of development of hidradenitis can be carried out either with a laser or with the use of antibiotics. Most often, in the third stage of treatment of this disease, an integrated approach to treatment is used.

Complex treatment of hidradenitis using antibiotics is usually prescribed. Most often these are Clindamycin and Rifampicin, which must be used 2 times a day for 2.3 months.

Sometimes antibiotic treatment for hidradenitis suppurativa does not give the desired result: abscesses heal poorly or reappear. In such a situation, doctors often prescribe tests such as microbiological analysis of pus and a swab from the nasal cavity.

These procedures will allow you to find out which microbes provoke the disease and what drugs can be used to combat them.

Staphylococcus aureus often lives in the nose and is resistant to most medications. Therefore, if it is the main causative agent of the disease, then specific treatment will be required.

Treatment of hidradenitis at home

You cannot self-treat with antibiotics for hidradenitis, even if it is possible to purchase them at a pharmacy without a prescription from a doctor. Treatment of hidradenitis (bitch udder) should only be carried out under the supervision of a doctor.

Sometimes drugs can cause an intestinal infection, similar in symptoms to poisoning.

The second stage of hidradenitis can be treated with laser. This method has been proven to be effective. The patient must attend 3-4 sessions per month.

If neither antibiotics nor laser help solve the problem, then you can consult your doctor about prescribing Infliximab. It contains antibodies that block substances that take part in autoimmune reactions.

The feasibility of using this drug was established due to the similarity of hidradenitis with Crohn's disease, in which characteristic abscesses most often form.

These diseases have a bad effect on skin tissue, leading to their pathologies.

Infliximab gives good results in the treatment of hidradenitis. It relieves pain and reduces inflammation.

But this drug has not been studied enough, so it is not yet possible to predict the consequences of its long-term use. Because of this, it is prescribed if other drugs do not help.

This treatment is carried out under the supervision of a doctor. Other drugs, like Infliximab, are not prescribed due to ineffectiveness or unsuitability in the treatment of hidradenitis.

Signs of hidradenitis in the groin

Symptoms

The appearance of one or sometimes several dense nodes in the groin can be a sign of various diseases. When diagnosing hidradenitis suppurativa in the inguinal region, it is important to differentiate it from an infected cyst, inguinal granuloma, lymphogranuloma venereum, cutaneous tuberculosis, actinomycosis and Crohn's disease.

The main criterion for diagnosis is the localization of the inflamed node in those areas of the skin where there are apocrine glands.

The general picture of the disease develops according to the following scheme:

• As soon as infection occurs, a compaction appears in the subcutaneous layer, accompanied by itching and pain.
• After a few days, the compaction area expands. Pus accumulates inside. The person begins to experience severe pain, and purulent fluid is released on the surface of the abscess.
• At the site of compaction, swelling and discoloration of the skin appear.
• With severe intoxication, the patient shudders and the temperature rises.

When pus accumulates in a large volume, the lesion can open without outside intervention or go inside the tissues.

The clinical picture of the disease develops gradually over several days. Depending on the location of the inflammatory process, the skin at the site of the gland lesion becomes hyperemic or slightly bluish.

When palpating the inflamed area, a rounded compaction is felt, sharply painful to the touch. As the pathological process progresses, an oblong infiltrate filled with pus is formed. All these symptoms are accompanied by signs of general intoxication of the body:

1. An increase in body temperature to 38.5-39 degrees;
2. Weakness;
3. Headaches and dizziness;
4. Nausea;
5. Lethargy, drowsiness.

The disease develops quite slowly. In the initial stages, a person may not attach much importance to redness on the skin, but his sweating will increase, weakness and slight itching in the groin or armpit may appear.

After a few days, a small, painful swelling (nodule) approximately the size of a pea appears in the affected area. The more time passes, the larger the bump becomes and changes its color to red-burgundy, the painful sensations, especially when touched, intensify.

Hidradenitis in the groin is considered the most unpleasant form of the disease, because it is painful for a person to move, sometimes even having to lie down constantly so as not to experience pain.

One or several new growths may appear on the skin at once, forming a whole set of painful lumps. The last stage of the disease is purulent discharge from foci of inflammation, while the bumps become softer and looser, and visible small holes appear in them.

Body temperature can reach 38-39 o C, weakness, fever, dizziness and migraines appear.

When the abscess is opened, pus mixed with blood comes out, and gradually the pain begins to subside, and the former ulcers heal and healed scars form.

The purulent process is usually accompanied by soreness, headache, fever, and general weakness

The most likely places where hidradenitis suppurativa can appear are in the armpits, in the groin area, under the breasts in women, on the nipples, in the anus and scrotum in men, on the labia majora in women, and in the umbilical area.

Symptoms of the development of hidradenitis suppurativa (bitch udder) include increased weakness and fatigue of the body, decreased human immunity, severe intoxication of the human body, periodic headaches, leukocytosis, cephalalgia and hyperemia.

Symptoms of hidradenitis are usually pronounced. At the beginning of the progression of the pathological process, when palpating an area of ​​skin, the presence of dense nodular formations can be determined. They are localized in the thick layer of the dermis or in the subcutaneous fat.

Gradually, the formations develop, and the following symptoms begin to appear:

• painful sensations increase significantly;
• formations increase in size;
• the inflammatory formation adheres to the skin and takes on a pear-shaped shape;
• the nodules rise above the skin in the form of papillae, which resemble the mammary glands of dogs. It was this symptom that became the reason that the disease began to be called “bitch udder”;
• the skin acquires a bluish tint;
• Edema appears around the formations.

Nodular formations tend to merge. After this, they gradually soften and can spontaneously open. Purulent exudate mixed with blood is released. Opening the formations relieves skin tension. As a result, the pain decreases and the ulcer that formed begins to heal.

If the formation is fully mature and ready for opening, then the indicated clinical picture is supplemented by the following symptoms:

• increased body temperature;
• increased pain. Now it is noted not only when pressing on the formation, but also in a state of complete rest;
• weakness;
• nausea;
• malaise.

In some cases, instead of the characteristic nodules, an infiltrate may form, which will look like a disc. Its structure is dense. This formation resolves over a long period of time.

Hidradenitis may recur. The following factors contribute to the resumption of the inflammatory process:

• lack of hygiene;
• ineffective treatment of primary hidradenitis;
• therapy was carried out untimely;
• the presence of underlying diseases that reduce the body’s immune defense.

Diagnostics

Diagnosis of hidradenitis begins with clarification of the patient's complaints. Next, a visual assessment of the scrotum is carried out, the number of rash elements and their sizes are determined.

Visually, nodules with hidradenitis are similar to a boil or tuberculous tubercle. The difference from a boil is the absence of a necrotic core.

A tuberculous tubercle does not cause a man significant pain, and with tuberculosis there are lesions of the lymph nodes before the formation of tubercles.

Examination plan for a patient with hidradenitis:

Due to the fact that the disease can occur in different ways and be localized in certain places, the diagnosis can be made by visual examination. Additionally, a blood test will be required. If hidradenitis is chronic, immunological studies are performed.

Recognizing the disease is not difficult for an experienced doctor. To clarify the severity of intoxication, you can take a general blood test, which will reveal neutrophilic leukocytosis and an increase in the erythrocyte sedimentation rate (ESR).

It will be useful to analyze the released pus for sensitivity to antibiotics, especially if taken before the start of antibacterial therapy. In the future, he will help you choose the right drug for relapse of hidradenitis.

In advanced chronic forms, accompanied by numerous lesions interconnected by tracts, ultrasound diagnostics of soft tissues is performed, which makes it possible to “examine” the structure of the subcutaneous tissue and optimize surgical intervention.

For diagnosis, a blood test is performed, which, if the disease is present, reveals signs of an inflammatory process.

In most cases, diagnosing hidradenitis does not present any difficulties. Due to the fact that the localization of inflammation is peculiar and also quite characteristic of the disease, first of all, a specialist conducts a thorough examination.

It is first necessary to distinguish hidradenitis from boils and colliquative tuberculosis. Hidradenitis does not have a necrotic core, so distinguishing it from a boil is not difficult.

As for colliquative tuberculosis, this disease is longer lasting than hidradenitis, and the disease first affects the lymph nodes, and the person does not feel pain.

Diagnosis is carried out in accordance with the characteristic clinical picture of hidradenitis. A blood test reveals signs of an inflammatory process: accelerated ESR, increased levels of leukocytes.

The protracted and recurrent course of hidradenitis entails a study of the immune system - an immunogram.

Diagnosis of hidradenitis is not difficult, since the diagnosis can be established during a visual examination of the patient. In order to accurately confirm it, clinical tests are prescribed.

As a rule, they show an increase in the level of leukocytes, a decrease in red blood cells, and an increase in ESR. All this suggests that an inflammatory process is developing in the human body.

If the disease occurs in a chronic form, then in this case the contents are collected from the formation in order to determine the sensitivity of the pathogen to certain antibiotics.

Treatment

Surgical intervention can be avoided only with proper treatment started at an early stage. Therapy includes the use of:

1. local antibacterial drugs (clindamycin, chlorhexidine, etc.);
   retinoids;
2. oral antibiotics (tetracycline, doxycycline, cephalosporin, etc.), the drug must be selected according to the sensitivity of the pathogen;
3. corticosteroids, they are prescribed when the effectiveness of antibacterial agents is low;
4. Oral contraceptives also sometimes have a beneficial effect on treatment outcome.

Important! In order to achieve remission or successfully treat hidradenitis on the labia, surgery is often required.

Considering that the causative agent is staphylococcus, antibiotics are indicated for hidradenitis. Antibacterial drugs are recommended to be prescribed in the form of ointments, topically. The following ointments are used:

1. Tetracycline;
2. Terramycin;
3. Erythromycin;
4. Levomikol.

Before prescribing an antibiotic, it is necessary to determine the sensitivity of the microflora and, based on the results of the analysis, use the most active one. In chronic cases, it is possible to prescribe antibiotics in the form of injections (cephalosporins, penicillins, macrolides).

Biological stimulants (methyluracil or pentoxyl) are prescribed along with antibiotics.

Considering that hidradenitis appears in men with weakened immune systems, the use of iron and phosphorus supplements is mandatory. Prescribe anabolic agents (nerobolil or retabolil). To increase the protective properties of the body, biological stimulants - methyluracil - are prescribed.

If a man is diagnosed with hidradenitis, treatment with Vishnevsky ointment is possible after opening the nodules. Compresses are applied to the scrotum.

A small amount of ointment is applied to the cotton wool, applied to the nodule and sealed with a band-aid. This compress must be kept for 12 hours, after which a new one is applied.

Before changing the compress, the scrotum is wiped with an antiseptic (hydrogen peroxide, chlorhexidine). Therapy with Vishnevsky ointment is carried out until all the pus is released. Before opening the elements, compresses with ichthyol are used.

If inflammation of the apocrine glands on the scrotum is detected in a man, treatment must be carried out in a hospital. However, if the stage of hidradenitis is mild, treatment at home is also possible after the doctor has prescribed all the necessary medications.

During the course of therapy, it is contraindicated to open the elements of the rash on your own, as there is a risk of infection entering the bloodstream and the disease becoming chronic.

The autopsy is performed in a sterile hospital environment, under anesthesia and if there are indications:

Therapy for hidradenitis can be carried out in a conservative or complex way. The conservative method involves treatment using medications:

• tetracycline and cephalosporin antibiotics in tablet form. The medicine is selected after a test for the sensitivity of the pathogen;
• ointments and bactericidal patches.

If antibiotics are not effective, your doctor may prescribe corticosteroids. A comprehensive treatment method involves the use of medications and surgery.

Treatment of hidradenitis under the arm should begin as early as possible, preferably at the stage of compaction formation. With timely medical care and proper treatment, the infiltrate can resolve at the initial stage.

If pain and a small nodule appears in the armpit, the doctor prescribes local treatment. The affected area and the skin around the infiltrate should be thoroughly treated with alcohol several times a day - this will destroy pathogens present on the surface of the skin and prevent the spread of the pathological process to the sebaceous glands.

A compress with Dimexide is applied to the affected area twice a day. During treatment, the patient should avoid intense physical activity and stress, take care of personal hygiene, and eat light, protein-rich meals.

With the development of hidradenitis suppurativa, antibiotics cannot be avoided. A drug only prescribed by a doctor, depending on the individual characteristics of the patient’s body, the severity of the disease, age and other factors.

In the early stages (before the appearance of an abscess), the disease is much easier to cure. The following is usually recommended as therapy:

1. Local, antibacterial, antimicrobial drugs: ointments and creams (for example, chlorhexidine, clindamycin, etc.)
2. Take antibiotics to treat hidradenitis and eliminate the infection from the inside through the blood (for example, cephalosporin, erythramecin, doxycyline, tetracycline, monocycline, etc.) Antibiotics for hidradenitis can only be prescribed by a specialist based on the sensitivity of the specific pathogen.
3. Taking special corticosteroids that increase the effect of antibacterial drugs.
4. In acute inflammatory processes, injections of triamcinolone into the affected area are recommended.

In addition to medications, the patient must adhere to a diet. Eliminate spicy foods, seasonings, alcohol from your diet and minimize the consumption of sweets, and be sure to stop smoking, otherwise treatment of hidradenitis at home will take a long time. In addition, in order for the “bitch udder” to disappear forever, you need to increase your immunity, for this you need to consult a doctor about immunostimulants, and also consume more vitamins, fruits, vegetables rich in iron and phosphorus, vitamins A, B, C, E.

It is extremely important to prevent the infection from spreading to other areas and sweat glands. During the day, treat the affected area with camphor or ethyl alcohol, brilliant green or iodine, and salicylic acid. During the entire treatment, you need to carefully cut the hair in the inflamed areas, do not allow moisture to get on it, and before taking a shower, it is better to cover the abscesses with an adhesive plaster.

If treatment of inflammation under the armpit or in the groin does not produce results within two weeks, or if you visit a doctor late, when hidradenitis suppurativa is already mature, surgical intervention cannot be avoided. The patient undergoes surgery to open the abscess, remove pus, and the entire infected area. After this, all treatment is reduced to wound healing. The patient is prescribed antibiotics, as well as painkillers and restoratives.

Antibiotics are prescribed for treatment

Therapeutic measures aimed at treating hidradenitis must be applied while the disease is not yet advanced, so you should consult a doctor in a timely manner, as it is much easier to cure hidradenitis without starting the problem until an abscess appears, which requires surgical intervention. Incorrect or delayed treatment of exacerbations contributes to a multiple increase in relapses of hidradenitis. Timely intervention, on the contrary, makes it possible to cure the disease within two weeks, even in an outpatient setting, although sometimes hospital treatment is required.

Under no circumstances should you open hidradenitis yourself, since hidradenitis must be treated comprehensively - excision of the abscess must be accompanied by drug therapy. As a rule, the doctor prescribes antibiotics, as well as autohemotherapy. If the patient exhibits symptoms of relapse of hidradenitis, then specific immunotherapy is used for treatment.

As a local therapy, ichthyol ointment is considered an effective remedy. At the time of discharge of purulent contents from the nodes, it should be used twice a day, changing the bandage each time. In addition, UHF, ultraviolet irradiation, and heat are successfully used.

For hidradenitis, along with medication, treatment with folk remedies is very actively used.

People often turn to their doctor with the question of what to do if I have hidradenitis (hidradenitis suppurativa, udder knots)? This article discusses only proven methods of treating hidradenitis suppurativa. Depending on various factors, this disease can be treated in different ways. The following are common cases and recommendations for each.

Hidradenitis cannot be treated surgically in the same way as regular abscesses. You cannot simply open the lump and remove the pus from it, and then treat the operated area with antiseptic agents and apply a bandage.

To remove a single abscess, surgery is the best option. But this method does not guarantee that the lump will not form again in the future. In almost all cases, an abscess will form again at the site of the removed formation. This is the reason why you cannot simply open the lump and drain the contents.

Today, according to new clinical studies, the doctor must not only do all of the above. He needs to remove as much subcutaneous tissue as possible from the area of ​​the abscess. This is the only way to prevent the reappearance of a lump at the site of the removed formation.

During pregnancy, this disease causes a decrease in immunity. Colds and herpetic diseases also contribute to the development of hidradenitis. Pregnant women with this disease are prescribed only topical antibiotics. If you notice the first symptoms, you should not delay going to the doctor; treatment of hidradenitis during pregnancy should not be delayed. If there is an extreme need, then it is possible to surgically remove the affected area, abscess, lump with hidradenitis, followed by the appointment of antibacterial procedures to reduce inflammation. It is better not to start hidradenitis, since during pregnancy it can leave undesirable consequences for both the expectant mother and her baby.

Patients are advised to wear loose clothing, as occlusion contributes to the exacerbation of hidradenitis. In the early stages of sluggish hidradenitis in the groin, local treatment with antibacterial agents (chlorhexidine, erythromycin, clindamycin) and retinoids is effective. In the acute stage, antibacterial therapy is necessary according to the pathogen (usually staphylococcus or streptococcus) and its sensitivity. Empirical antibiotic therapy in patients over 8 years of age begins with tetracycline, doxycycline, or minocycline. Clindamycin and cephalosporins are also effective. Sometimes therapy with tetracycline or erythromycin is required for a long time. At an early stage, administration of triamcinolone acetonide (5-10 mg/ml) into the lesions is successful. If the effectiveness of antibacterial drugs to suppress inflammation is weak, prednisone is prescribed (40-60 mg/day for 7-10 days with gradual withdrawal) to reduce the development of fibrosis and scarring. Sometimes oral contraceptives with a predominance of estrogens over progestogens and low androgenicity of the latter and oral retinoids have a beneficial effect. Warm compresses speed up the breakthrough of the abscess, but if there is a pinhole, the abscess must be opened surgically and drained. Surgery is often required to achieve remission or cure hidradenitis in the groin.

The presence of this type of formation brings many unpleasant moments, especially if the location is the groin area. Sometimes, due to lack of time, embarrassment, or the hope that “it will go away on its own,” patients do not seek help from specialists in a timely manner. Although in fact, the sooner you start treating hidradenitis in the groin area, the less painful the therapy will be for a person.

Treatment of hidradenitis should mainly occur under the close supervision of a specialist. Basically, therapy using nitrofurans, antibiotics, and sulfonamides is prescribed to treat the disease. Autohemotherapy can also be used. When a patient develops forms of recurrent hidradenitis, immunotherapy can be used to treat it and medications can be prescribed that have a general strengthening effect on the body.

Ichthyol ointment has been successfully used as a drug for local treatment of hidradenitis. During the period of pus discharge from the nodes, Ichthyol lozenge is used twice a day. At the same time, dry heat, UHF, ultraviolet irradiation, as well as walks in the fresh air are used for complex treatment.

Treatment of hidradenitis is carried out using both conservative and radical methods. It is also possible to treat pathology at home using folk remedies. The optimal method of treatment is determined only by a doctor based on a visual examination, assessment of the stage of development of the inflammatory process, as well as test results.

Methods of conservative treatment of hidradenitis are used most often. They are quite effective and can completely cure the pathology. The following medications and procedures are prescribed:

• antibacterial therapy. To effectively treat hidradenitis, you should definitely use antibiotics, since it is this group of drugs that most effectively fights pathogenic microorganisms. Medicines from the tetracycline series, as well as the macrolide class, are usually prescribed. They are prescribed both in tablets and injections;
• Hormonal therapy during the treatment of hidradenitis is also often used, since hormonal drugs can influence various phases of inflammatory processes. Glucocorticoid drugs are administered directly to the site of inflammation;
• specific immunotherapy. The main purpose of its purpose is to stimulate immune processes in the body;
• retinoid drugs;
• local therapy;
• UV irradiation of the skin;
• centimeter wave therapy.

Radical treatment of hidradenitis is indicated if pus with bloody streaks is released from the formation. Installation of drainage will not bring success, since at this stage of development of the pathological process many small abscesses form in the infiltrate. It is impossible to drain all of them and therefore pus will continue to be released.

The essence of surgical treatment of hidradenitis is that, under anesthesia, the doctor makes a deep incision that reaches healthy tissue. Next, not only the purulent contents are removed, but also the infiltrated fatty tissue. After the wound has healed, the patient is prescribed to take antibacterial drugs and undergo physical therapy.

Physiotherapeutic procedures that are prescribed after surgical treatment of pathology:

• infrared therapy;
• photochemotherapy;
• magnetic laser therapy.

Treatment with folk remedies

Hidradenitis can also be treated at home using folk remedies. But it is worth noting that self-medication is not recommended.

Any folk remedies can be used only with the permission of the attending physician, and in tandem with conservative therapy. Not all traditional medicine that works for one person will work for another.

Their uncontrolled use can only worsen the patient's condition.

Treatment at home begins with providing the patient with complete rest and changing his diet, including foods that contain all the microelements, vitamins and minerals the body needs.

The process of development of hidradenitis, complications and consequences

Untimely treatment of the disease threatens the development of diffuse purulent tissue lesions of phlegmon. If lymph nodes are located near the apocrine glands, an advanced form of hidradenitis may result in lymphadenitis.

How can hidradenitis suppurativa (bitch udder) develop?

Hidradenitis is a very dangerous complication such as blood poisoning. Therefore, if you discover an abscess that is accompanied by fever and chills, you should quickly seek help from a surgeon. Boils also leave noticeable scars.

You can eliminate them using some methods, which include:

1 Surgical removal of the scar and special care of the operated area by a plastic surgeon;

2 Injection of glucocorticoid hormones into the scar;

3 Injection of 5-fluorourocil into the required area;

4 Cryogenic therapy;

5 Radiation therapy;

6 Compression treatment;

7 Use of laser for resurfacing concave and convex scars;

8 Using a laser method to remove the color of a scar if it has a color different from the skin;

9 Dermabrasion;

10 Chemical peeling;

11 Fillers;

13 Trimming and cutting out scars.

Prevention

To protect yourself from such an unpleasant disease, it is advisable to follow preventive measures:

• give preference to loose-fitting clothes made from natural fabrics;
• lead a healthy lifestyle (stop smoking, drinking alcohol);
• adjust the daily menu in favor of healthy low-calorie dishes;
• carry out water procedures regularly.

When the disease has already struck, the risk of spread can be prevented by taking into account the following rules:

• replace baths with showers;
• remove hair in the perineal area using delicate methods;
• strictly follow the rules of personal hygiene, using safe cosmetics;
• wear loose underwear;
• treat inflamed areas with a solution of potassium permanganate.

Prevention of hidradenitis consists of following the rules of hygiene, taking care of the skin of the axillary and groin areas, treating diabetes mellitus, and strengthening the immune system.

With chronic hidradenitis, it is useful to sometimes expose the affected area to sunlight, in other words, to allow the skin of the armpits to tan a little.

The patient must have his own towel and his own clothing in contact with the body (for example, a robe or T-shirt).

With timely treatment, the prognosis is favorable.

The main principle of preventing hidradenitis is maintaining good hygiene. You should also pay attention to the clothes you wear: they must match the air temperature and humidity.

Overweight people need to normalize their body weight. Inappropriate cosmetics and perfumes should be avoided.

In general, a healthy lifestyle and high-level immunity are the key to success in any case.

Hidradenitis is an acute inflammatory-purulent lesion of the sweat glands of infectious origin. The main cause of the disease is considered to be staphylococcus. The inflammatory process is predominantly localized in the axillary region, in the navel, anus and genital area.

The disease is usually diagnosed in women aged 16-60 years. The peak incidence is observed during puberty and with hormonal imbalance. In most cases, hidradenitis does not affect children or men.

Causes of the disease

Hidradenitis as a type of pyoderma (purulent lesion of the skin) is formed against the background of infection of the skin by pathogens.

The main causative agent of the disease is considered to be Staphylococcus aureus, which penetrates the sweat gland in two ways:

• through microtrauma of the epidermis;
• through the lymphatic system from other foci of suppuration.

For example, shaving hair under the armpit or in the groin may be accompanied by cuts to the skin, which subsequently serve as an “entry gate” for coccal infection. Doctors identify the following risk factors:

• excessive sweating;
• systemic decrease in the level of immunity;
• a sharp change in hormonal levels.

Symptoms of hidradenitis

The disease occurs in two main forms: unilateral and bilateral inflammation. In women, unilateral suppuration of the sweat glands is predominantly diagnosed.

In the initial stage, a single painful nodule forms in the thickness of the skin, and when pressed, the patient experiences an attack of pain.

Gradually, such a pathological focus increases in size and its surface itches. This also causes a sharp reddening of the skin. Over time, several nodules combine into one purulent infiltrate.

At the stage of a developed clinical picture, the patient has the following symptoms:

• increase in body temperature up to 38⁰С;
• severe pain in the affected area of ​​the epidermis;
• general weakness and chronic malaise;
• attacks of slight nausea.

In the later stages of the disease, an abscess opens in the central part of the inflamed infiltrate and pus is released. In such purulent masses, blood particles are detected. This stage of the disease often resembles a boil.

The average duration of hidradenitis is 10-14 days. After the discharge of pus, a scar forms at the site of the rash.

After the breakthrough of purulent masses, a person must carefully observe the rules of personal hygiene, since the pus contains a large number of staphylococci. These microorganisms, after penetrating into nearby parts of the skin, can provoke the development of an additional purulent process.

Photo of hidradenitis

Diagnosis of the disease

The doctor diagnoses hidradenitis according to the following program:

• Finding out the patient’s medical history and subjective complaints.
• Visual inspection of the affected part of the body and palpation of regional lymph nodes. The purulent-inflammatory process is usually accompanied by enlargement and soreness of nearby lymph nodes.
• Laboratory blood test. Hidradenitis causes an increase in the number of leukocytes and SOE levels in the circulatory system.

Which doctor should I go to?

It is impossible to cure hidradenitis on your own at home; prolonging the disease will only lead to complications.

After detecting signs of suppuration of the sweat gland, the patient is prohibited from applying dry heat to the pathological area.

The opening of the purulent focus and the prescription of conservative therapy for such diseases is carried out by the surgeon.

Treatment methods for hidradenitis

Treatment of purulent-inflammatory processes of the skin is carried out using the following methods:

• Drug therapy. In most cases, antibacterial therapy is considered the basic method of therapy. Antibiotics are prescribed to eliminate acute signs of the inflammatory process.

• Amoxiclav 0.5 g 2 times a day, 7 days;
• Ceftriaxone 1 or 2 grams 1 time per day, 7 days;
• Azithromycin (tablets or suspension) 0.5 g once a day, 3-6 days;

The information is provided for informational purposes only. Self-prescription of such drugs can lead to chronic forms of pyoderma. In addition, antibiotics have contraindications; various factors must be taken into account, so a personal consultation with a doctor is necessary.

Treatment with antibacterial agents is carried out in tablet and injection form. In most cases, antibiotic injections provide a more lasting and effective therapeutic effect compared to taking pills. After intramuscular injections, the maximum concentration of the antibacterial agent is achieved after 20-30 minutes and persists for 6-8 hours.

• Surgical autopsy abscess. Radical intervention is the main treatment for hidradenitis, which consists of dissecting the pathological infiltrate with a scalpel. This manipulation is performed under local anesthesia. During the operation, the specialist opens the abscess and installs a special rubber strip to drain the pus. The drainage is removed 3-4 days after radical intervention.

Method of surgical treatment of hidradenitis

Radical intervention for purulent lesions of the sweat glands includes the following steps:

• Local anesthesia. Anesthesia of the superficial layers of the skin is carried out using injections of novocaine or lidocaine.
• Surgical opening of ulcers. The doctor uses a scalpel to dissect the area of ​​protrusion of the infiltrate. The length of the incision is usually 2-4 cm.
• Removal of purulent masses and nearby subcutaneous tissue. Radical excision of inflamed and modified skin tissue helps prevent the development of relapse.
• Rinsing the surgical field with antiseptic solutions, which should be at room temperature.
• Installation of drainage, which is a sterile rubber strip or tube. Drainage ensures unimpeded drainage of pus for several days.

Wound care after radical intervention is carried out according to the following rules:

• At home, the patient should wash the surgical incision area daily with weak antiseptic solutions.
• The patient must come to the surgeon every day for examination and washing of the wound surface.
• The surgeon removes the drainage mainly 3-4 days after surgery, after which the incision area is covered with a sterile bandage.

Consequences and complications of hidradenitis

Purulent-inflammatory damage to the sweat glands can be complicated by the following diseases:

• Phlegmon – this is a diffuse purulent process of soft tissues, which is a consequence of the spread of staphylococcal infection from the primary focus. This complication is accompanied by a sharp increase in body temperature and a significant deterioration in the patient’s general well-being.
• Abscess . Limited suppuration of the skin is characterized by the formation of an inflammatory capsule, which prevents further spread of infection.

Attention! Treatment of phlegmons and abscesses is exclusively surgical and requires immediate hospitalization in a surgical hospital.

• Sepsis , which is the most severe consequence of hidradenitis. This complication is a purulent lesion of the circulatory system. Penetration of staphylococcal infection into the blood often ends in death.

Disease prognosis

Hedradenitis is a purulent disease with a predominantly favorable outcome. Timely treatment with the use of drug therapy and surgical opening of the abscess ensures the patient’s full recovery. Treatment is carried out on an outpatient basis and only after complications are detected, the patient is subject to emergency hospitalization.

The negative consequences of the disease are usually associated with late seeking of medical help and self-medication at home.

In some people, a scar forms at the site of purulent lesions of the gonads.

If scarring of the surface layers of the skin causes discomfort in the patient, doctors recommend laser resurfacing of the scars.

A favorable prognosis for the disease is also ensured by taking antibiotics, which effectively prevent the development of complications of hidradenitis.

Prevention of purulent lesions of the sweat glands

Preventive measures for hidradenitis are carried out at several levels:

1. Preventing infection from entering the sweat glands by observing personal hygiene rules and antiseptic treatment of the area of ​​accidental damage to the epidermis.
2. Timely treatment of diseases of the endocrine system, which are accompanied by hormonal imbalance.
3. A person who discovers signs of suppuration in certain areas of the skin should immediately seek specialized medical help.
4. Treatment of the purulent-inflammatory process is carried out with the use of an antibiotic. Such drugs, as a rule, should have a wide range of effects, which eliminates the development of many bacterial complications.

Hidradenitis has a pronounced clinical picture, and a qualified specialist, without any particular difficulties, is able to establish the correct diagnosis and prescribe comprehensive treatment for the disease. Antibiotic therapy and surgical opening of the abscess contribute to a favorable outcome of the disease and the absence of complications.

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All information is presented for educational purposes. Do not self-medicate, it is dangerous! Only a doctor can make an accurate diagnosis.

The groin contains many apocrine glands that produce sweat. The risk of inflammation (development of hidradenitis) in this area is as high as in the axillary area. In the early stages there are no difficulties with diagnosis, the disease is treated successfully. But the difficulty lies in the patient’s delay in seeing a doctor due to the sensitivity of the problem. In later stages, surgery is indicated as a therapeutic measure.

Inflammation of the sweat glands most often occurs from staphylococcal bacteria.

Description

Hidradenitis in the groin, like a chest lesion, involves inflammation of the sweat glands, which is localized in the scrotum, anus, and large genital folds. As the inflammatory process develops, suppuration occurs. People of both sexes and different ages are equally susceptible to the disease.

The pathology is not hereditary. The maximum frequency of visits regarding illness is recorded in the summer, when a person is more often in hot and humid rooms.

In most cases, hidradenitis genitalis is caused by staphylococcal infection. Complications of hidradenitis localized in the groin area, for example, sepsis, are dangerous. The disease can recur and is often accompanied by abscessed acne with an epithelial coccygeal tract, say experts from the Clinic of Cosmetology and Dermatovenereology.

Features of the flow

Hidradenitis is always accompanied by a purulent process, so it is often confused with a boil. The main difference between hidradenitis is the absence of a central focus (rod). The causative agent of the infection penetrates the apocrine glands through ducts and small abrasions. Usually the process is localized in a group of sweat-producing elements.

In women, hidradenitis develops on the labia (only on the labia majora; it does not occur on the labia minora due to the lack of sweat secretors). There are three forms of flow:

• acute;
• complicated;
• chronic.

In the last two cases, clusters of fistulas form, after healing of which rough fibrous scars form on the skin. If the acute disease is not treated, it becomes chronic with frequent exacerbations.

Typically, hidradenitis begins with blockage of the glandular duct with debris consisting of destroyed epithelial and bacterial cells. Due to the increase in pressure on the walls of the duct, it stretches above the blockage with further rupture in the lower part. The damaged areas become inflamed with the formation of a large area of ​​pus. Then external fistulas are formed, which, when tightened, leave scars.

Histological picture

With the development of hidradenitis in the groin and genitals, dense horny plugs form in the glandular tubules and the mouths of the hair follicles. As a result, adhesions of the ductal outlets occur with the formation of an expanded cyst on the follicle. In some cases, inflammation affects the glandular body.

As hidradenitis develops, nearby tissues become inflamed. The main pathology is accompanied by a coccal infection with damage to the sweat secretions and deep layers of the epidermis. The skin scars and narrows in an obliteration pattern that requires surgery as treatment.

Causes of hidradenitis in the groin in women

The main cause of damage to the apocrine glands is infection with staphylococcus. Cases of infection with Proteus and streptococci are recorded less frequently. Provoking factors:

• violation of personal hygiene rules for caring for the intimate area;
• hormonal imbalances;
• changes in the functioning of the endocrine system caused by age-related or physiological characteristics;
• increased sweating, since the composition of sweat is favorable for the development of pathogenic bacteria;
• disturbances of material metabolism;
• weakened immunity as a result of pregnancy, stress, overexertion, chronic diseases, surgery, HIV, taking drugs that stop the activity of components of the immune chain;
• the predominance of tight clothing and underwear made of synthetic material in the wardrobe;
• abnormal development of the excretory duct of the sweat secretor.

The following may increase your risk of developing hidradenitis:

• skin diseases, for example, dermatitis, eczema;
• skin damage such as wounds, scratches, scratches.

The skin and hair follicles are damaged during shaving and hair removal. Pathogens enter through the injured area, causing an inflammatory process.

Symptoms

The general clinic for men and women with inguinal and thoracic hidradenitis develops as follows:

1. On the first day of infection, a compaction forms in the subcutaneous layer. The affected area is very itchy and sore.
2. After 3-5 days, the size of the compaction increases. Pus accumulates inside and adheres to the nearest tissue. The abscess hurts, pus appears on its surface.
3. There is severe swelling in the area of ​​infiltration with a change in the color of the skin above and around the lesion, which becomes purplish-bluish in color.
4. The pain intensifies.
5. With the onset of severe intoxication of the body, fever, chills, and malaise appear.

If a lot of pus accumulates, the lesion may open on its own, but may go inside the tissues. After self-removal of the extrudate, the wound heals, leaving a rough scar.

In pregnant women

The causes of hidradenitis of the sweat glands during pregnancy are associated with weakened immunity, failure to comply with personal hygiene rules, acute respiratory viral infections, and herpes infection. Symptoms of hidradenitis:

• a sharp increase in body temperature;
• malaise;
• pain in the inflamed area.

If a clinical picture of hidradenitis appears during pregnancy, you should immediately consult a doctor to open the abscess and clean it. Additionally, a course of anti-inflammatory and local antibacterial therapy is prescribed. Otherwise, the risk of developing severe complications that will adversely affect the health of the mother and fetus increases.

Diagnostics

The disease has a unique localization, clinical picture and a number of features of its course, so the diagnosis is made during the initial examination by a specialist. At the same time, apocrine secretory hidradenitis is differentiated from other similar pathologies:

• with furunculosis there is a rod in the inflamed lesion, with hidradenitis there is none;
• With colliquative tuberculosis, the course is longer, the lymph nodes are immediately affected, and there is no pain.

Additionally, differentiation is carried out with infected epidermal cysts, actinomycosis, cat scratch disease, granulomatosis, lymphogranuloma in HIV. Difficulty arises in differentiating pathology from Crohn's disease.

Additionally, blood is taken for analysis to identify signs of the inflammatory process:

• increased ESR;
• a jump in the level of leukocytes.

In case of chronic, recurrent course of hidradenitis, immune examinations are carried out with the preparation of an immunogram.

Treatment

Hidradenitis in an intimate area can be cured with two existing approaches. A conservative method is prescribed drug therapy:

• Tetracycline and cephalosporin antibiotics in tablets. The drug is selected based on the results of a sensitive test regarding the pathogen.
• Bactericidal ointments for compresses and plasters (Clindamycin, Chlorhexidine).
• Alcohol treatment of the affected skin around the inflamed area.
• Corticosteroids if antibiotics don't work.
• Oral contraceptives.

A combined method that includes drug treatment and surgical techniques. Treatment occurs in several stages:

• Dissection of the abscess during surgery, followed by sanitation and drainage of the cavity. The operation is carried out with antibiotic cleaning.
• Diet therapy aimed at reducing weight in obesity.
• Vitamin therapy.
• Treatment of underlying diseases.

The inflammatory process in the sweat secretions tends to recur over time. Based on the compilation of the patient’s immunogram, required for chronic hidradenitis and frequent relapses, immunocorrection is carried out.

In the groin area, as in the armpit, there are many apocrine sweat glands. Therefore, hidradenitis in the groin does not develop much less often than under the armpit or in any other place. But not everyone decides to immediately go to the doctor and show inflammation. This localization of the disease transfers it to the category of intimate and delicate diseases. But you can’t hesitate! Timely and adequate treatment is necessary.

Causes of development of hidradenitis in the groin

Important! in the groin, on the genitals, under the armpit, near the nipples and anus, it appears most often in adolescence or in the post-pubertal period.

The cause of inflammation of the apocrine glands is most often staphylococci, but Proteus, streptococci and other representatives of microflora unfriendly to humans can become. Provoking factors include:

Failure to comply with hygiene rules can cause the development of hidradenitis in the groin.

• serious hormonal disorders or minor changes in the functioning of the endocrine system associated with age, physiological and other characteristics;
• metabolic diseases;
• reduced immunity;
• wearing tight and uncomfortable clothes and underwear;
• preference for synthetic fabrics when choosing clothing items;
• failure to comply with hygiene standards.

If one or more dense nodes are detected, you need to pay close attention to your health, monitor its development and, without hesitation, consult a doctor.

Hidradenitis inguinalis, symptoms

The appearance of one or sometimes several dense nodes in the groin can be a sign of various diseases. When diagnosing the groin area, it is important to differentiate it from an infected cyst, inguinal granuloma, lymphogranuloma venereum, cutaneous tuberculosis, actinomycosis and Crohn's disease. The main criterion for diagnosis is the localization of the inflamed node in those areas of the skin where there are apocrine glands.

Gradually, the nodes increase in size (from 0.5 to 3 cm or more) and begin to cause discomfort and acute pain, itching unbearably. The skin in the affected area becomes purple or bluish. Body temperature may rise to 38–39 degrees. When subcutaneous tissue is involved in the process, they speak of the spread of a purulent infection - phlegmon. Then the prognosis becomes less favorable. At some point, the abscess may open. Healing may occur with scar formation.

Hidradenitis in the groin, treatment

Surgical intervention can be avoided only with proper treatment started at an early stage. Therapy includes the use of:

1. local antibacterial drugs (clindamycin, chlorhexidine, etc.);
   retinoids;
2. orally (tetracycline, doxycycline, cephalosporin, etc.), the drug must be selected according to the sensitivity of the pathogen;
3. corticosteroids, they are prescribed when the effectiveness of antibacterial agents is low;
4. Oral contraceptives also sometimes have a beneficial effect on treatment outcome.

Important! In order to achieve remission or successfully treat hidradenitis on the labia, surgery is often required.

Prevention

If one node occurs in the groin, care must be taken to ensure that the infection does not spread to other sweat glands. To do this, do the following:

• carefully trim the hair growing in the affected area;
• for bathing they use only a shower (a bath is strictly contraindicated);
• the site of inflammation should be wiped twice a day with a slightly pink solution of potassium permanganate;
• to enhance the effectiveness of treatment, stop smoking and drinking alcohol, spicy foods and seasonings;
• clothing must correspond to environmental conditions;
• It is important to follow the rules of hygiene and strictly approach the choice of cosmetic skin care products.

It is difficult to diagnose hidradenitis on the labia independently and successfully treat it without surgery. This is partly due to the fact that patients are reluctant to show their illness to the doctor, hoping that everything will resolve itself. In addition, in such a delicate place, it is almost impossible to discern the problem before pain symptoms appear and to take proper care of the skin. Therefore, in most cases, hidradenitis on the external genitalia and groin area can only be treated surgically.

Hidradenitis is a purulent inflammation of the apocrine sweat glands, which is caused by the penetration of a staphylococcal infection along the hair follicle (see photo).

Hidradenitis can be observed in the armpits, around the anus, on the scrotum, near the labia and navel, i.e. wherever there is hair.

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Hidradenitis - what is it?

Hidradenitis is popularly called “bitch udder” for its resemblance to a dog’s chest. This disease is not observed in children and elderly people. This is due to the fact that apocrine glands begin to actively function only after puberty, and by the age of 50-55 their activity begins to decline.

Women suffer from hidradenitis more often than men. The risk especially increases during the peak of puberty and menopause due to frequent shaving of the armpits.

It is quite simple to identify hidradenitis suppurativa, because it has several characteristic features. The inflammation exceeds 1.5 cm in diameter and visually resembles a boil.

The peculiarity of hidradenitis is the absence of a necrotic core. The pathological focus protrudes noticeably above the surface of the skin, and the entire convex surface is painted bright red. There is swelling and pain around the inflamed area.

Hidradenitis under the armpit and in the groin area, photo

Purulent inflammation of the apocrine sweat glands in 98% of cases is caused by a bacterium such as Staphylococcus aureus. Minor damage is enough for the pathogen to get under the skin. The epidermis can be injured during shaving, depilation, and epilation.

• The use of deodorants, which irritate and dry out the skin, thereby promoting the appearance of microcracks, has a detrimental effect.

Hidradenitis under the armpit

The risk of infection of the apocrine gland increases in people who suffer from excessive sweating. A wet substance that is constantly on the skin reduces its barrier functions. Pathogenic microflora easily enters the lymphatic ducts or the mouth of the hair follicle, and an inflammatory process develops.

Insufficient hygiene also provokes hidradenitis under the armpit. The reasons may lie in disruption of the endocrine glands: diabetes, obesity, hormonal imbalance.

The catalyst for the appearance of hidradenitis is a decrease in immunity and a violation of the acidity of sweat - alkalization.

Hidradenitis in the groin area

Hidradenitis in the groin occurs less frequently, but it still happens in women and men of reproductive age. This is due to non-compliance with hygiene rules during sexual intercourse.

Many people immediately fear that this is a sexually transmitted disease. But if shaving or hair removal was done immediately before close contact, most likely we are talking about hidradenitis.

The inflammatory process can spread to the armpits and genitals if there are already purulent foci in the body. In this case, hidradenitis will have a slightly different nature. For this reason, ulcers in any area cannot be allowed to become chronic.

Symptoms of hidradenitis - features

At the stage of infiltration (initial development), you can notice the appearance of small nodules that are dense to the touch. Hidradenitis under the armpit or in the groin area, which is out of sight, will manifest itself with unpleasant symptoms: itching, pain when pressed.

• Immediately after the appearance, the nodule will rapidly increase in size and take on a pear-shaped shape. The size of the inflammatory lesion reaches 1.5 - 3 cm.

The hidradenitis ganglion is tightly adherent to the skin, which in the convex area becomes red-violet. As inflammation develops, the nodules merge with each other. Painful sensations appear not only when touched, but also at rest.

The maturation process of hidradenitis is necessarily accompanied by:

1. General malaise;
2. Fatigue;
3. Painful itching sensations around the inflammation;
4. Increased body temperature.

Hidradenitis in the groin, the symptoms of which are already unpleasant, will cause severe pain when walking. Such manifestations take a person out of his daily schedule for several days until the abscess finally matures.

After ripening, the central zone of the node becomes soft. After 1-2 days, hidradenitis may spontaneously open. Quite a lot of purulent masses with a small amount of blood substances will be released from the inflamed area.

Blood enters the node due to damage to blood vessels during its rapid growth. Bleeding with hidradenitis never occurs - it is always the release of blood in a small amount.

After the pus is released, the person feels relief: the temperature drops and strength returns. The node disappears, but an ulcer appears in its place. After a few days, it heals and a scar appears on the skin.

• Often the scar will remain sunken inward for some time. Then, as new connective tissue forms, the scar area smoothes out.

Hidradenitis can recur and transform into a chronic disease. Spontaneous opening of the node may not occur at all. In this case, the patient’s condition will worsen and he will require urgent medical care in the form of emergency surgery.

Treatment of hidradenitis - drugs and antibiotics

The success of therapy largely depends on at what stage the patient discovers a node in the groin area or hidradenitis under the arm. Treatment of hidradenitis must begin from the moment of the first lumps under the skin. For ease of manipulation, the hair in the affected area is cut off (shaving is prohibited, as this can aggravate the course of the purulent process).

The node and the surrounding area are treated with an antiseptic, which will reduce pain (the possibility of an allergy to a particular substance must be taken into account):

• Iodine 5%;
• Salicylic acid 2%;
• Brilliant green 3%;
• Ethyl alcohol 96%.

The wider the affected area, the more the node will hurt. To relieve discomfort, an abscess larger than 2 cm is injected with 1% novocaine with the addition of an injectable vasoconstrictor. The latter reduces the diameter of the vessel and thereby prolongs the effect of the anesthetic.

In the treatment of hidradenitis, oil-based ointments and gels are prohibited - they can provoke the spread of suppuration. For the same reason, the use of compresses is prohibited, only dry heat is allowed. The best option is to apply alcohol-drying dressings.

Alcohol-free warming can be done:

• Natural fabric heated with an iron (application method);
• Using a blue lamp for 5-7 minutes (distance to the node is at least 20 cm);
• Ultraviolet radiation (open sun) for no more than 30 minutes.

When is surgery indicated?

If hidradenitis does not clear up on its own, surgery is necessary. It will most likely not be possible to get by with local puncturing (piercing) and drainage, because there are multiple foci of suppuration.

• Hidradenitis is opened using a full incision. First, the pus is removed, and then the inflamed subcutaneous fatty tissue is cut out.

The wound after surgery turns out to be quite voluminous. Covering it with bandages is strictly prohibited - constant treatment with antiseptic agents is required, as well as access to air (for better regeneration). After the inflammation goes away, granulation of the wound occurs.

After the granulation stage, a second operation is necessary if the tissue defect is very large. During this procedure, subcutaneous fatty tissue and the skin itself are removed. Next, the patient requires autodermoplasty - moving sections of tissue from the operated person to hide cosmetic defects.

Otherwise, a rough scar will remain on the skin. Hidradenitis in the groin is especially unpleasant - treatment in women and men with a radical method should be carried out with extreme caution. Such localization can affect the health of the reproductive organs if there is a deep spread of the pathological process.

After surgery Physiotherapy may be prescribed:

• Laser;
• Magnetic therapy;
• Localized UV therapy;
• Infrared radiation;
• Ultrasound therapy;
• Electrophoresis with unithiol, dianine, codeine;
• X-ray exposure – removes sweat glands, therefore it is used only in case of constant recurrence of inflammation.

Some of these procedures may be prescribed during the period of infiltration. In some cases, they help avoid surgery.

The patient must follow a diet aimed at restoring the proper functioning of the body's glands. Moreover, the function of such a diet is to strengthen the immune barrier. Any sweets, alcohol, spicy foods and seasonings, and strong coffee are prohibited. At the same time, nuts (walnuts and almonds), citrus fruits, apples, carrots, red and black berries, dried fruits, and honey should appear on the table.

Ginseng, aloe, rose hips, and plantain have healing properties that restore immunity. Decoctions from them should be drunk instead of tea or added to tea leaves.

Antibiotics

Treatment of hidradenitis should be carried out not only outside, but also inside the body. Antibiotics (erythromycin, doxycycline) can significantly improve the patient's condition. These drugs can be used at all stages of treatment. Antiseptics are most effective during initial suppuration (before relapses).

If a relapse occurs, an immunogram is necessary (especially for multiple relapses). According to the study, immunostimulants are prescribed.

• The goal of therapy is to completely destroy staphylococcal bacteria. They fight the pathogen by injection: gamma globulin, Staphylococcus aureus vaccine.

In parallel with the treatment of hidradenitis ganglion, inflammation in other apocrine sweat glands is prevented. A staphylococcal infection can spread to any part of the body, but the patient can protect the surrounding glands.

It is necessary to treat not only the node itself, but also the space around it with an antiseptic solution (diamond green, iodine, ethyl and boric alcohol). The area that needs treatment is limited to “intimate areas”: armpits, perineum, navel. In other locations, the appearance of hidradenitis is almost impossible.

Before taking a shower, bath or other water treatments, hidradenitis must be bandaged. The patch will prevent the infection from spreading throughout the body.

Complications of hidradenitis

Hidradenitis should never be confused with a classic pimple, abscess or boil. Untimely or incompetent treatment can seriously affect the patient's health.

Axillary hidradenitis transforms into a large abscess if surgery or drainage is not performed correctly. The culprit is inflamed subcutaneous fatty tissue. An abscess affects soft tissue and makes treatment very difficult.

Hidradenitis can become a putrefactive cellulitis if surgery is not performed in two stages. A second autopsy is necessary, because even in the stage of an ulcerative wound, the node recurs.

Another risk is the development of chronic lymphadenitis. This complication is possible if the staphylococcal bacteria entered the body through the lymphatic channel. Refusal to treat hidradenitis threatens the patient with sepsis and puts his life at risk.

Hidradenitis: which doctor should I contact?

Any skin disease brings a person to a dermatologist; it is this doctor who should conduct the initial examination. Next, the patient can be referred to doctors who treat the cause of the inflammation:

• Immunologist;
• Endocrinologist;
• Infectious disease specialist.

In addition, during the treatment process you will need the help of a nutritionist or allergist.

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