Hidradenitis Suppurativa

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Image of Hidradenitis Suppurativa

VisualDx images show variation in age, skin color, and disease stage. VisualDx has 47 images of Hidradenitis Suppurativa.

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ICD Codes

ICD-9-CM:
705.83 – Hidradenitis

ICD-10-CM:
L73.2 – Hidradenitis suppurativa

Synopsis

Hidradenitis suppurativa is a destructive, chronic inflammatory disorder of the terminal follicular epithelium in apocrine gland-bearing regions. This disease was once thought to be caused by bacterial infection, but it has now become clear that it is a noninfectious acneiform disease. It is believed that follicular occlusion leads to trapping of follicular contents, rupture, and inflammation of the dermis, with bacterial superinfection in some cases. Hidradenitis suppurativa is more common in women and blacks.

The nodules of hidradenitis suppurativa are seen most commonly on the buttocks, breasts, and in the groin and axillae. Usually, the onset of the disease occurs soon after puberty, and patients typically report recurring "boils." Shaving, depilation, deodorants, and mechanical irritation can worsen this condition, but irritation of the skin is usually not a major factor. Obesity and cigarette smoking are associated with hidradenitis suppurativa. Symptoms may include arthralgias and local pain and tenderness during a flare-up.

Interestingly, hidradenitis suppurativa shares similar clinical features (severe inflammation, occlusion of the follicle, and scarring) with dissecting cellulitis of the scalp and acne conglobata. Collectively, these 3 conditions are referred to as the follicular occlusion triad, and more than one may occur in a given patient. Some consider the pilonidal sinus (pilonidal cyst) to be an additional member of this group.

With a prevalence of up to 1% in some population-based studies, hidradenitis suppurativa is a common disease.

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