Abstract

Hidradenitis Suppurativa (HS) is an inflammatory disorder of pilosebaceous apocrine unit of terminal hair bearing skin, most commonly in the axillae and groin, or inguinal area, perineum, buttocks and mons pubis, sometimes scalp, other sites may be affected. It is a complex, chronic condition that requires a multidisciplinary care team. Most of the patients report hindered sexuality, and poor sexual functioning, while showing good levels of dyadic and solitary sexual desire, despite no associations between clinical severity and sexuality. The presence of negative psychological factors (i.e., multiple personality disorder, anxiety, pain, depression) increase the risk of sexual impairment, which underline the important role of psychological and sexual aspects in HS patients. While a General Practitioner (GP) may help with initial diagnosis and basic symptom management, dermatologists and surgeons are the primary specialists equipped to treat the disease effectively across its different stages. Recent clinical data highlights unique, association with metabolic syndrome leading to region-specific high comorbidity rate, and higher mortality than the general population demanding better care of HS. General Practitioner (GP) / Primary Care Provider are the initial Point of Contact as most often the first health person a patient sees for painful lumps or abscesses. GP Can diagnose early-stage HS, prescribe initial treatments like medicated creams or antibiotics, and provide necessary referrals to dermatologists. Dermatologists &STD specialist who specialize in inflammatory skin conditions, the key specialists to confirm diagnoses, design individualized treatment plans, and prescribe advanced therapies like immunosuppressants and targeted biologic medications and considering the effect of disease burden on patients’ sexual health must also address them. Surgeons are required for Hurley Stages II and III or when abscesses need drainage surgical excision of affected tissue & reconstructive skin flaps. In India multipolarity hospitals in cities may have such team but public sector facilities lack in sub-district or even some district headquarters.

Materials and Methods

This article based 3 cases the author has followed and documented to alert general practitioners, about the need and urgency for early clinical diagnosis and appropriate referral and follow-up especially after surgical intervention.

Keywords:Folliculitis; Acne; Pyoderma gangrenosum; Skin abscesses

Abbreviations: HS= Hidradenitis Suppurativa; MS= Metabolic Syndromes; TBT= Targeted Biologic Therapies