Hydradenitis: causes, symptoms and treatment
Author: surgeon Yurevich VV
Human skin is a very complex organ, performing a variety of functions. Of all the surgical skin diseases, hydradenitis is most common.
Hydradenitis is an acute purulent inflammation of the sweat glands of the skin. Despite the fact that the sweat glands completely cover the skin of the person, the hydradenite is located mainly in the axillary and less often in the inguinal areas of the body. In order to understand what a hydradenite is, it is necessary to understand what a sweat gland is and what it consists of.
The gland gland looks something like a pear, the thickened part of which is deep in the skin, and its narrow part - the excretory duct opens on the surface of the skin next to the hair. Through this duct, sweat produced by the gland, flows to the surface of the skin and moisturizes it.
When inflammation of the sweat gland in the first place there is swelling of its excretory duct, which is already very narrow, is clogged up completely. Infected sweat in this case does not have the possibility of outflow, it extends the sweat gland, which increases in size and is inflated. There is a small intradermal abscess.
The reason for hydradenite
The main cause of development of hydradenitis is infection. On the human skin there are countless different microorganisms that, with microtraumas of the skin of the axillary and inguinal areas, which is often the case with an inadvertent shave, full people with skin friction during intense physical activity, especially during the hot season, get into the sweat gland, causing its inflammation.
Also to the development of hydradenitis predispose various endocrine diseases, diabetes, as well as all diseases accompanied by a decrease in body immunity.
Due to the typical localization and characteristic symptoms, in most cases, the hydradenitis presents no difficulties for diagnosis not only for doctors, but for absolutely any person.
Signs of the appearance of hydradenitis
Externally, hydradenitis is a small swelling in the skin of the armpit, which has a number of specific characteristics. This formation is reddish, swollen, sharply painful both at rest and during a touch. The disease begins gradually with the appearance of a small tubercle on the skin, which for several days gradually increases in size, and these sizes can vary widely from millet grains to chicken eggs. At the same time, there is a gradual increase in pain, which takes the form of permanent, pulsating, sleep depriving people. Often in patients there is an increase in body temperature and general malaise.
Because of the characteristic species of hydradenite among the people, the name "bitch udder" has long been attached to it because of the similarity with the nipple of the nursing dog.
Most often, hydradenitis affects one sweat gland, respectively, thus forming a single subcutaneous abscess. However, it is not uncommon for cases when hydradenitis affects several sweat glands, including simultaneous damage to both armpits.
With a favorable course of this disease, it develops sharply, within two to three days there is suppuration of the sweat gland, the abscess opens itself, the pus comes out and within a few days self-healing begins. However, in some cases, with untimely treatment, the purulent process can spread beyond the sweat gland. This creates a diffuse purulent inflammation of the axillary region, which, due to complex anatomical features, can spread to the shoulder, under the large thoracic arm, under the scapula and even around the neck.
That is why in all cases of hydradenitis timely surgical care is necessary. Only this approach can effectively prevent the occurrence of severe complications.
Another peculiarity and problem of hydradenitis is its fairly frequent recurrence, that is, the re-emergence again in the same place. There are patients who are operated dozens of times, but despite this, the abscesses occur again and again. This once again underscores the importance of timely and adequate treatment as the best preventative measure for complications.
The main method of treatment of acute purulent hydradenitis is surgical. There are two basic methods of operations with hydradenitis:
1. Opening of hydradenite. The operation consists in dissection of the skin of the armpit above the abscess, the pus is evacuated and after a short period of ligation the wound heals. However, this method has a significant drawback - frequent relapses of the disease due to the fact that the inflamed sweat gland is not removed, which subsequently causes a repeated suppuration.
2. Excision of hydradenitis. This type of operation is considered radical, that is, after its implementation, the hydradenite at this site, as a rule, no longer appears. The essence of the operation is that the inflamed sweat gland with pus is excised within the healthy tissues, and the wound is then sewn up.
In the vast majority of cases, hydradenitis, regardless of the type of operation, is operated in a polyclinic under local anesthesia. Only in neglected cases, especially in the presence of multiple hydradenitis, hospitalization of the patient in the hospital is necessary, where he is operated under general anesthesia.
As a rule, hydradenitis proceeds favorably, no serious complications arise. However, it should be remembered that with frequent exacerbations, repeated appearance of abscesses, despite a radically performed surgical intervention, one should think about whether such a course of hydradenitis is the result of any serious disorders in the body. In such cases, in addition to surgical treatment, a thorough, comprehensive examination of the patient is necessary.
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