Hydradenitis: causes, symptoms and treatment
Author: Surgeon Yurevich V.V.
Human skin is a very complex organ that performs a variety of functions. Of all the surgical diseases of the skin, hydradenitis is the most common.
Hydradenitis is an acute purulent inflammation of the sweat glands of the skin. Despite the fact that the sweat glands cover the human skin completely, hydradenitis is located mainly in the axillary and less often in the inguinal areas of the body. In order to understand what constitutes hydradenitis, you need to understand what a sweat gland is and what it consists of.
The sweat gland looks like a pear, the thickened part of which is located deep in the skin, and its narrow part - the excretory duct opens on the skin surface next to the hair. Through this duct, the sweat produced by the gland flows to the surface of the skin and moisturizes it.
In inflammation of the sweat gland, first of all, there is swelling of its excretory duct, which, being very narrow, is completely blocked. Infected sweat does not have the possibility of outflow to the outside, bursting with a sweat gland, which increases in size and suppurate. There is a small intradermal abscess.
Cause of hydradenitis
The main cause of hydradenitis is infection. Countless different microorganisms inhabit the human skin, which, in case of microtraumas of the axillary and inguinal skin, which quite often occurs when shaving carelessly, in obese people during friction during intense physical activity, especially in the hot season, get inside the sweat gland, causing her inflammation.
Also to the development of hydradenitis predispose various endocrine diseases, diabetes, as well as all diseases, accompanied by a decrease in the immunity of the body.
Due to the typical localization and characteristic symptoms in hydradenitis, in most cases it presents no difficulty in diagnosing, not only for doctors, but for absolutely anyone.
Signs of Hydradenitis
Externally, hydradenitis is a slight swelling on the skin of the armpit, which has a number of specific characteristics. This formation of reddish color, edematous, sharply painful both at rest and at the time of touch. The disease begins gradually with the appearance of a small tubercle on the skin, which gradually increases in size over several days, and these sizes can vary widely from millet grain to chicken egg. At the same time, there is gradually increasing pain, which takes on the character of constant, pulsating, depriving a person of sleep. Often, patients have fever and malaise.
Due to the characteristic type of hydradenitis, the name “suck udder” has long been established among the people because of the similarity with the nipple of a nursing dog.
Most often, hydradenitis affects one sweat gland, respectively, thus forming a single subcutaneous abscess. However, there are cases when hydradenitis affects several sweat glands, including with simultaneous damage to both underarms.
With a favorable course of this disease, it develops acutely, within two to three days there is suppuration of the sweat gland, an abscess opens up on its own, the pus comes out and within a few days self-recovery occurs. However, in some cases, in case of late treatment, the purulent process may extend beyond the sweat gland. At the same time, a diffuse purulent inflammation of the axillary region occurs, which, due to its complex anatomical features, can spread to the shoulder, under the pectoralis major, under the scapula, and even to the neck.
That is why in all cases of hydradenitis, timely provision of surgical care is necessary. Only with such an approach can the occurrence of severe complications be effectively prevented.
Another feature and problem of hydradenitis is its rather frequent recurrence, that is, re-occurrence again in the same place. There are patients who are operated on dozens of times, but despite this, ulcers appear again and again. This once again underlines the importance of timely and adequate treatment as the best measure of prevention of complications.
The main method of treating acute purulent hydradenitis is surgical. There are two main methods of operations for hydradenitis:
1. Opening of hydradenitis. The operation consists in dissecting the skin of the armpit over the ulcer, the pus is evacuated and the wound heals after simple short bandages. However, this method has a significant drawback - frequent recurrences of the disease due to the fact that the inflamed sweat gland is not removed, which later becomes the cause of re-suppuration.
2. Excision of hydradenitis. This type of operation is considered radical, that is, after its implementation, hydradenitis in this place, as a rule, no longer appears. The essence of the operation is that the inflamed sweat gland with pus is cut out within the limits of healthy tissue, and the wound is then sutured.
In most cases, hydradenitis, regardless of the type of operation, is operated in the clinic under local anesthesia. Only in advanced cases, especially in the presence of multiple hydradenitis, the patient must be hospitalized in a hospital, where he is operated on under general anesthesia.
As a rule, hydradenitis occurs favorably, does not cause any serious complications. However, it should be remembered that in case of frequent exacerbations, repeated occurrences of ulcers, despite radical surgery, one should consider whether this course of hydradenitis is a consequence of any serious disturbances in the body. In such cases, in addition to surgical treatment, careful, comprehensive examination of the patient is necessary.
author: doctor Shevchenko N.G.
When examining each patient, the doctor should pay attention to the condition of the lymph nodes. But why, not every patient thinks about it. In fact, such a simple examination can give a lot of clues about the state of health and reactivity of the body's immune system.
Author: Surgeon Denisov MM
Before talking about axillary lymphadenitis, it is necessary to understand what lymphadenitis is in general.