Bitch udder between legs. Hydradenitis in the groin. Hydradenitis formed in the inguinal zone

Hidradenitis is a purulent inflammation of the apocrine glands. The main prerequisites for the onset of the disease is a staphylococcus infection.

As stated above, hidradenitis is a disease of the sweat glands. As a rule, the disease is formed in the armpits, since the skin there is rich in sweat glands, occasionally - near the navel, labia and male scrotum. The category of risk naturally includes women.

Basically, the disease proceeds in a unilateral form. First, single dense nodules of not very large volume appear in the skin. They cause itching and a slight painful sensation, which increases when you press the nodule itself. These nodules tend to grow rapidly and transform into large (1.5 cm) pear-shaped nodes connected to the skin. The nodules come to the surface of the skin, in appearance resembling breast nipples.

The skin at the site of the formation of nodes acquires a red-blue color, a slight edema forms and a strong pain reaction occurs. Single nodes are able to connect with each other, creating a large accumulation of dense consistency, which has a disk-like shape. Severe pain occurs not only during the movement of the patient, but also at rest. The presented situation indicates the node maturation period. This usually accompanies the following symptoms: a painful condition, fever, identified pain syndrome.

After a certain time, the main part of the nodes softens and they open with
emission of purulent masses. The texture of the purulent masses resembles thick cream and may have a blood admixture. A characteristic difference between hydradenitis and the usual furuncle is the absence of a necrotic rod. The opening of the node, as a rule, occurs 6-10 days after its appearance, which contributes to a significant improvement in the state of the body and a reduction in pain.

At the site of the opened hydradenitis, a wound is formed that heals over time and leaves a scar. The full period of formation of hydradenitis and its opening takes approximately 2 weeks.

The inflammatory process under the arm develops due to clogging of the sweat glands or due to the follicle. If there are scratches or wounds on the skin, they can contribute to the development of acute inflammation in the human body. Through the blood vessels or through the lymphatic system, there is a direct invasion of the infection. There, microbes intensively reproduce, which contributes to the development of a disease called hydradenitis. It can also develop at the time of hormonal restructuring of human systems.

Risk group:

diabetes;
reduced immune forces of the body;
weakened body after illness;
overweight and obesity;
improper functioning of the sex glands;
poor or insufficient skin hygiene;
microtrauma during shaving;
frequent use;
polluted working conditions.

Hydradenitis in the groin

Hydradenitis in the groin is an inflammatory process caused by the invasion of infection into the apocrine glands located in the genitals. This kind of hydradenitis is known under the name "bitch's udder".

This disease is formed in the female, as a rule, in adolescence or after adolescence. In certain cases, it predicts the occurrence of irritation and discomfort in the inguinal zone. Painful formations appear on the skin, which can grow to a deep abscess.

The disease can also develop on the labia majora. After the wounds have healed, lingering scars appear in place. However, this does not apply to the labia minora, since their surface does not have sweat glands.

Complications or a protracted course of the disease often give large "families" of fistulas. After them, rough fibrous scars are noted on the pubic skin and external genitalia. Without proper treatment, the disease can bother for many years, and the stages of remission will certainly be replaced by a severe exacerbation.

Hydradenitis in the groin has many significant aggravations of the condition:

fistulas that may appear on the urethra, bladder, rectum, peritoneum;
ulcers;
purulent arthritis;
severe abscesses that may affect adjacent structures;
phlegmon.

How to treat this disease

Women with hidradenitis in the groin are strongly advised to wear loose underwear made from natural material, as squeezing the skin helps increase inflammation, as well as the spread of infection. If the disease has a weak course, then at the initial stage local therapy with the use of antibacterial drugs will be quite effective. For example, the groin area can be treated with a solution chlorhexidine, smear ointments, which include erythromycin And retinoids.

The use of warm compresses can bring the breakthrough of a purulent formation closer, but it is still better when the abscess is opened with surgical method. After the release of purulent contents, the ulcer must be drained. The operation is needed for complete treatment and for the acquisition of the remission stage.

When prescribing treatment, it must be remembered that without proper therapy it will not work.
and do not try to squeeze out the contents of the gland yourself. This is very risky due to the fact that pathogenic bacteria can enter the circulatory system and provoke an infectious disease - sepsis with a fatal outcome. The disease does not tolerate moisture. For this reason, you should not carry out compresses and take a long bath. It is allowed to wash in the shower, in advance it is required to seal the place with a band-aid.

Doctors treat this disease with sulfonamides and antibiotics. They can be taken orally or injected. In acute illness, an injection is used Triamcinolone from Lidocaine. If suppuration occurs, an autopsy is performed and a drainage system is inserted to drain the liquid contents.

Protracted course is treated with antibiotics: Lincomycin, Erythromycin, Isotretinoin, Tetracycline, Oleandomycin, minocycline, Ristomycin.

In severe cases, corticosteroid hormone is used - Prednisone(70 mg per day, decreasing the dose over time). If it turned out that the causative agent is staphylococcus aureus, then the doctor additionally prescribes immunotherapy and an injection against staphylococcus infection.

For the purpose of local therapy, ointments are used: Levomekol, Clindamycin, Neomycin, Levosin etc. As a rule, such treatment is enough for small nodes.

Limit sugary treats and hot spices and enrich the menu with the following products:

Vitamin decoctions will be of great benefit - rose hips, various berries, sea buckthorn oil, infusions of leuzea, eleutherococcus.

In order to prevent the disease, you should:

Strictly comply with hygiene requirements.
Use high quality cosmetics.
Antiperspirants should be thoroughly washed off before going to bed.
With cuts obtained during shaving, it is required to treat them with alcohol, iodine.
Do not wear tight clothing made of synthetic materials.
Reduce excess body weight.
Fight sweating.
Maintain immunity.

With the help of such simple methods, the occurrence of the disease can be avoided.

The mechanism of the development of the disease

Basically, the inflammation is unilateral. The process can also manifest itself in the groin (hydradenitis in the groin). Much less often, the inflammatory process affects the area around the nipples, as well as in the scrotum, anus, labia majora (hydradenitis on the labia), in the folds under the mammary glands in women.

In connection with the similarity of abscesses with the mammary glands of dogs, people gave the disease hydradenitis the name "bitch's udder." Many characterize the disease as "red bumps", "subcutaneous abscesses", "painful seals", etc.

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

Causes

Important! A bitch udder in the groin, on the genitals, under the arm, 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:

Not following the rules of hygiene 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;
excessive sweating;
metabolic diseases;
reduced immunity;
wearing tight and uncomfortable clothes and underwear;
preference for synthetic fabrics when choosing garments;
non-compliance with hygiene standards.

If one or more dense nodes are found, you must carefully consider your health, monitor the development of symptoms and, without hesitation, consult a doctor.

Hormonal failure of the body can cause hydradenitis

In many cases, the main cause of hidradenitis is infection with staphylococcus aureus. In medical practice, cases have also been recorded when streptococci turned out to be the provocateur of the disease.

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

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

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

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

The main reason for the appearance of hidradenitis is the development and reproduction of bacteria and microorganisms on vulnerable or inflamed human skin. Most often, the causative agent of infection becomes Staphylococcus aureus, but representatives of streptococci and Proteus can settle. Some factors can provoke inflammation of the sweat gland under the arm or in the groin, for example:

May be due to excessive sweating

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

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

Classification

By the nature of the course of the pathological process:

acute purulent hydradenitis;
chronic hydradenitis.

By localization of the lesion:

bilateral;
unilateral.

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

When many nodes, bumps, abscesses appear in the groin, under the armpits or under the breasts in women that are close to each other and occupy a large amount of the body, the doctor speaks of the third stage of the development of hydradenitis.

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

Usually, a complex treatment of hidradenitis with the use of antibiotics is prescribed. Most often, these are Clindamycin and Rifampicin, which must be applied 2 times a day for 2.3 months.

Sometimes antibiotic treatment for purulent hydradenitis does not give the desired result: abscesses do not heal well or reappear. In such a situation, doctors often prescribe the passage of such studies as a 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 fight them.

Staphylococcus aureus often lives in the nose and does not respond to most drugs. Therefore, if it is the main causative agent of the disease, then specific treatment will be required.

Treatment of hidradenitis at home

You can not independently be treated with antibiotics for hidradenitis, even if it is possible to purchase them at a pharmacy without a prescription from a doctor. Treatment of hidradenitis (bough udder) should be carried out only 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 a laser. This method has been proven to be effective. In this case, the patient needs to attend 3-4 sessions per month.

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

The feasibility of using this drug has been 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 tissues, 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.

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

Signs of hidradenitis in the groin

Symptoms

Purulent hidradenitis is accompanied by acute pain at the site of localization of the nodes.

The appearance of one, and sometimes several dense knots in the groin can be a sign of various diseases. When making a diagnosis of purulent hidradenitis of the inguinal region, it is important to differentiate it from an infected cyst, inguinal granuloma, venereal lymphogranuloma, skin 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 seal appears in the subcutaneous layer, accompanied by itching and pain.
After a few days, the compaction area expands. Pus builds up inside. A person begins to be disturbed by severe pain, a purulent liquid is released on the surface of the abscess.
At the site of compaction, swelling appears, discoloration of the skin.
With severe intoxication, the patient is shivering, the temperature rises.

With the accumulation of pus in a large volume, the focus can open without third-party 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 lesion of the gland becomes hyperemic or slightly cyanotic.

On palpation of the inflamed area, a rounded seal 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:

An increase in body temperature to 38.5-39 degrees;
weakness;
Headaches and dizziness;
nausea;
Lethargy, drowsiness.

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

A few days later, a small, painful swelling (nodule) about 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, painful sensations, especially when touched, intensify.

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

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

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

When an abscess is opened, pus with an admixture of 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, general weakness

The most likely places where purulent hidradenitis may appear are 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, in the umbilical region.

Symptoms of the development of purulent hidradenitis (bough udder) include increased weakness and fatigue of the body, decreased human immunity, severe intoxication of the human body, recurrent headaches, leukocytosis, cephalgia and hyperemia.

Symptoms of hydradenitis are usually pronounced. At the beginning of the progression of the pathological process, when probing a skin area, it is possible to determine the presence of dense nodular formations. They are localized in the thick layer of the dermis or in the subcutaneous fat.

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

painful sensations are greatly enhanced;
formations increase in size;
the inflammatory formation is soldered to the skin and becomes pear-shaped;
the nodules rise above the skin in the form of papillae, which resemble the mammary glands of dogs. It was this symptom that caused the disease to be called "bitch's udder";
the skin becomes bluish;
edema appears around the formations.

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

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

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

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

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

poor hygiene;
ineffective treatment of primary hidradenitis;
therapy was carried out out of time;
the presence of background diseases that reduce the immune defense of the body.

Diagnostics

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

The tuberculous tubercle does not bring pronounced pain to a man, and also 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 proceed 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 carried out.

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

An analysis of the discharged pus for sensitivity to antibiotics, especially taken before the start of antibiotic therapy, will be useful. In the future, he will help you choose the right drug for recurrence of hidradenitis.

With advanced chronic forms, accompanied by numerous foci, interconnected passages, ultrasound diagnostics of soft tissues is performed, which allows you to "examine" the structure of the subcutaneous tissue and optimize the surgical intervention.

For diagnosis, a blood test is performed, in which, in the presence of an ailment, signs of an inflammatory process are revealed.

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

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

As for collicative tuberculosis, this disease is longer 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. In the blood test, signs of the inflammatory process are revealed: the acceleration of ESR, an increased level of leukocytes.

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

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

As a rule, they have an increase in the level of leukocytes, a decrease in erythrocytes, as well as an increase in ESR. All this suggests that an inflammatory process is developing in the human body.

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

Treatment

It is possible to do without surgical intervention only with proper treatment, started at an early stage. Therapy includes the use of:

local antibacterial drugs (clindamycin, chlorhexidine, etc.);
retinoids;
oral antibiotics (tetracycline, doxycycline, cephalosporin, etc.), the drug must be selected in accordance with the sensitivity of the pathogen;
corticosteroids, they are prescribed with low effectiveness of antibacterial agents;
oral contraceptives also sometimes have a beneficial effect on the outcome of treatment.

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

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

Tetracycline;
Terramycin;
Erythromycin;
Levomikol.

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

Together with antibiotics, biological stimulants (methyluracil or pentoxyl) are prescribed.

Given that hidradenitis appears in immunocompromised men, the use of iron and phosphorus preparations is mandatory. Anabolic agents are prescribed (nerobolil or retabolil). To increase the protective properties of the body, biological stimulants are prescribed - methyluracil.

In the case of a diagnosis of hidradenitis in a man, treatment with Vishnevsky ointment is possible after opening the nodules. Compresses are applied to the scrotum.

A small amount of ointment is applied to cotton wool, applied to the knot and sealed with a plaster. Such a 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's ointment is carried out until all the pus comes out. Before opening the elements, compresses with ichthyol are used.

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

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

An autopsy is performed in a sterile hospital environment, under anesthesia and if indicated:

Treatment of hidradenitis involves a complex method

Therapy for hydradenitis can be carried out in a conservative or complex way. The conservative method involves treatment with the use of medicines:

antibiotics of the tetracycline, cephalosporin series in the form of tablets. The medicine is selected after a test for the sensitivity of the pathogen;
ointments and patches of bactericidal action.

If antibiotics don't work, your doctor may prescribe corticosteroids. A complex method of treatment involves the use of drugs and surgery.

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

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

Twice a day, a compress with Dimexide is applied to the site of the lesion. During treatment, the patient should exclude increased physical activity and stress, monitor personal hygiene, eat light, protein-rich meals.

With the development of purulent hidradenitis, antibiotics cannot be dispensed with. A drug prescribed only by a doctor, depending on the individual characteristics of the patient's body, the severity of the course of the disease, age and other factors.

In the early stages (before the appearance of an abscess), the disease is much easier to cure. As a therapy, it is usually recommended:

Topical, antibacterial, antimicrobial agents: ointments and creams (e.g. chlorhexidine, clindamycin, etc.)
Take antibiotics for the treatment of hidradenitis and eliminate the infection from the inside through the blood (eg cephalosporin, erythramecine, doxycilin, tetracycline, monocycline, etc.) Only a specialist can prescribe antibiotics for hidradenitis based on the sensitivity of a particular pathogen.
Reception of special corticosteroid agents that increase the effect of antibacterial.
In an acute inflammatory process, triamcinolone injections are recommended at the site of the lesion.

In addition to medications, the patient must adhere to a diet. Exclude spicy foods, seasonings, alcohol from the diet and minimize the use of sweets, and be sure to stop smoking, otherwise the treatment of hydradenitis at home will drag on for a long time. In addition, in order for the "bitch's 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, salicylic acid. During the entire treatment, you need to carefully cut the hair in the inflamed areas, prevent moisture from getting on them, it is better to seal the abscesses with adhesive tape before taking a shower.

If the treatment of inflammation under the armpit or in the groin does not give results within two weeks, or if you see a doctor late, when purulent hydradenitis has already matured, you cannot do without surgical intervention. The patient undergoes an operation to open the abscess, remove pus, and the entire infected area. After that, all treatment is reduced to wound healing. The patient is prescribed antibiotics, as well as painkillers and tonics.

Antibiotics are prescribed for treatment

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

In no case do not open hydradenitis on your own, since it is necessary to treat hydradenitis in a complex way - excision of the abscess should be accompanied by drug therapy. As a rule, the doctor prescribes antibiotics, as well as autohemotherapy. If the patient shows 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 the release of purulent contents from the nodes, it should be used twice a day, each time changing the bandage. In addition, UHF, ultraviolet irradiation, and heat are successfully used.

With hydradenitis, along with drug exposure, treatment with folk remedies is very actively used.

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

Hidradenitis is not surgically treated in the same way as it happens with ordinary abscesses. You can’t just open the bump and remove pus from it, and then treat the operated site with antiseptics and apply a bandage.

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

Today, according to new clinical studies, the doctor must not only do all of the above. He needs to remove the maximum amount of subcutaneous tissue in the area of the abscess. This is the only way to prevent the reappearance of the bump at the site of the removed formation.

During pregnancy, this disease contributes to a decrease in immunity. The development of hidradenitis is also helped by colds and herpetic diseases. Pregnant women with this disease are prescribed only topical antibiotics. If the first symptoms are detected, the trip to the doctor should not be postponed, the treatment of hydradenitis during pregnancy should not be postponed. If there is an urgent need, then it is possible to surgically remove the affected area, abscess, bumps with hydradenitis, followed by the appointment of antibacterial procedures to reduce inflammation. It is better not to start hydradenitis, 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 exacerbates hidradenitis. In the early stages of sluggish current hidradenitis in the groin, topical treatment with antibacterial agents (chlorhexidine, erythromycin, clindamycin) and retinoids is effective. In the acute stage, antibiotic therapy is necessary according to the pathogen (usually staphylococcus or streptococcus) and its sensitivity. Empiric antibiotic therapy in patients older than 8 years is started 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, the introduction of triamcinolone acetonide (5-10 mg / ml) into the foci is successful. If antibacterial drugs are not effective enough to suppress inflammation, prednisone (40-60 mg/day for 7-10 days with gradual withdrawal) is prescribed 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 hasten the rupture of the abscess, but a pinhole requires the abscess to be opened surgically and drained. Surgery is often required to achieve remission or cure hidradenitis in the groin.

The presence of this kind of education brings a lot of unpleasant moments, especially if the location is the inguinal region. Sometimes, due to lack of time, embarrassment or hope for the principle of “it will pass by itself”, patients do not turn to specialists in time for help. Although in fact, the sooner you start treating hydradenitis in the inguinal region, 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 with the use of nitrofurans, antibiotics, sulfonamides is prescribed for the treatment of the disease. Autohemotherapy may also be used. When a patient develops forms of recurrent hidradenitis, then immunotherapy can be used to treat it, prescribe medications that have a general strengthening effect on the body.

As a drug for the local treatment of hydradenitis, Ichthyol ointment is successfully used. During the period of pus release from the nodes, Ichthyol cake is used twice a day. At the same time, dry heat, UHF, ultraviolet irradiation, as well as outdoor walks 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 with the help of folk remedies. The optimal method of treatment is established only by a doctor based on a visual examination, an 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 allow you to completely cure the pathology. The following medications and procedures are prescribed:

antibiotic therapy. To effectively treat hidradenitis, antibiotics should be used, since it is this group of drugs that most effectively fights pathogenic microorganisms. Usually prescribed drugs from the tetracycline series, as well as the macrolide class. They are prescribed both in tablets and in injections;
hormone therapy during the treatment of hidradenitis is also often used, since hormonal drugs can influence various phases of inflammatory processes. Glucocorticoid drugs are injected immediately into the focus of inflammation;
specific immunotherapy. The main purpose of its appointment is to stimulate immune processes in the body;
retinoid preparations;
local therapy;
UVI of the skin;
centimeter wave therapy.

Radical treatment of hidradenitis is indicated if pus with bloody streaks is released from the formation. The installation of drainage will not bring success, since at this stage of the 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 stand out.

The essence of the surgical treatment of hidradenitis is that, under anesthesia, the doctor makes a deep incision that reaches healthy tissues. Further, not only purulent contents are removed, but also infiltrated fatty tissue. After the wound heals, the patient is prescribed to take antibacterial drugs, as well as go to physiotherapy.

Physiotherapeutic procedures that are prescribed after surgical treatment of pathology:

infrared therapy;
photochemotherapy;
magnetic laser therapy.

Treatment with folk remedies

You can treat hydradenitis at home with the use of 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 suits one person will suit another.

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

Treatment at home begins with the fact that they provide the patient with complete rest and change his diet, including products containing all the microelements, vitamins and minerals necessary for the body.

The process of development of hidradenitis, complications and consequences

Untimely treatment of the disease threatens with the development of a diffuse purulent lesion of phlegmon tissues. If lymph nodes are located near the apocrine glands, an advanced form of hydradenitis can threaten lymphadenitis.

How can purulent hydradenitis (bitch udder) develop?

Hidradenitis is very dangerous with such a complication as blood poisoning. Therefore, if an abscess is detected, which is accompanied by fever and chills, it is necessary to seek help from a surgeon as soon as possible. The boils also leave visible 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 site;

3 Enter by injection of 5-fluorourocil in the desired area;

4 Cryogenic therapy;

5 Radiation therapy;

6 Compression treatment;

7 The use of a laser for resurfacing concave and convex scars;

8 Using a laser method to eliminate the color of the scar, if it has a color that is distinctive from the skin;

9 Dermabrasion;

10 Chemical peeling;

11 Fillers;

13 Cutting and cutting scars.

Prevention

Regular water procedures are important

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 (quit smoking, drinking alcohol);
adjust the daily menu in favor of healthy low-calorie dishes;
regularly carry out water procedures.

When the disease has already overtaken, you can prevent the risk of spread if you consider the following rules:

bathing is replaced by a shower;
remove hair in the crotch area in delicate ways;
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 in observing the rules of hygiene, caring for the skin of the axillary and inguinal areas, treating diabetes, and strengthening the immune system.

In chronic hydradenitis, it is sometimes useful to expose the affected area to solar radiation, in other words, to let the skin of the armpits tan a little.

The patient should have his own towel and his own clothes in contact with the body (for example, a dressing gown or T-shirt).

With timely treatment, the prognosis is favorable.

The main principle of prevention of hydradenitis is the observance of hygiene rules. You should also pay attention to the clothes you wear: they must correspond to the temperature of the air and its humidity.

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

In general, a healthy lifestyle, immunity at a high level is the key to success in any case.

Inflammatory disease of the apocrine sweat glands of the scrotum, or hidradenitis in the groin, is a common condition among young men. Due to the high amount of melanin skin pigment and excessive sweating, hidradenitis is more common in black people than in white-skinned men.

Hydradenitis is a disease of young men, since the functions of the apocrine sweat glands fade with age. Also, inflammation of the apocrine glands is not observed in children. The age group that is most susceptible to hidradenitis of the scrotum are young guys in puberty and men taking hormonal drugs.

Hidradenitis is seasonal. It is more common in spring and summer when the ambient temperature is high. This is due to the appearance of favorable conditions for the reproduction of microorganisms in the sweat glands.

Hydradenitis of the scrotum occupies a leading place among all inflammations of the apocrine glands in men. Also, the frequency of occurrence is higher in men who have had cases of this disease in the family. In patients who are overweight, the sweat glands of the scrotum become inflamed twice as often than in men with normal body weight.

Hydradenitis is an infectious disease. The causative agents are:

Golden ;
Pseudomonas aeruginosa;
Yeast-like fungi.

The causative agent enters the apocrine gland from the environment, clothing, personal hygiene products, dust. Staphylococci also live on the skin of every healthy person. The most common causative agent is staphylococcus, as it mainly affects the appendages of the skin (sweat glands,).

Normally, the infectious causes of hidradenitis cannot enter the apocrine gland, since the skin and its derivatives have a special anti-infective barrier. The functioning of the skin is impaired if traumatic factors are present:

Injuries, violation of the integrity of the skin (especially when using reusable razors and careless depilation procedure);
Neglect of the rules of personal hygiene, a rare change of underwear;
Hypothermia of the whole body or overheating of the scrotum due to wearing tight synthetic underwear in hot weather;
Metabolic disorders, especially carbohydrates in diabetes mellitus;
Lack of vitamins in the body due to malnutrition or diseases of the gastrointestinal tract;
General chronic diseases;
Hormonal imbalance.

Hidradenitis risk groups are people working in agriculture, miners, athletes, men working in conditions that do not meet sanitary standards.

You can also become infected with hidradenitis pathogens during intercourse when the injured skin comes into contact with the partner's skin, on which the pathogen lives.

Hydradenitis can be caused by the frequent use of deodorants for the intimate area, especially before physical exertion.

Symptoms

If the question arises when hidradenitis appears, which doctor to contact, the answer is dermatologist, since hidradenitis refers to dermatological diseases. Therefore, the appearance is considered the main symptom, and its main element is the papule (nodule). It can be single or multiple, reaches the size of a pea.

As the disease progresses, the nodules increase. When touched, the papule is painful, dense. The skin around the nodule is hyperemic.

The nodules contain pus. Within a few days, the pus melts the nodule, causing it to become soft. The last stage in the development of the papule is its opening, in which pus comes out. Often a man can notice blood impurities. After the release of all the contents, the wound heals and a small scar forms. After the opening of the nodule, the pain subsides.

With hydradenitis of the scrotum, a man notes a deterioration in his general condition:

Body temperature rises, headache appears;
General weakness, fatigue, drowsiness;
Decreased work capacity.

Normalization of the general condition occurs after the opening of the nodule and the formation of a scar.

The number of purulent nodules can reach several dozen. If left untreated, new elements of the rash will appear, and the disease will turn into a chronic form with constant relapses, which gives a number of serious complications, up to blood poisoning and death. In a person who started treatment on time, the disease lasts no more than two weeks.

In all cases, the disease begins acutely and progresses rapidly. The severity of symptoms increases every day. During the period of the disease, a man's sexual function is impaired, since any touch on the scrotum and sexual intercourse bring pain.

Diagnostics

Diagnosis of hidradenitis begins with the clarification of the patient's complaints. Next, a visual assessment of the scrotum is carried out, the number of elements of the rash and their size are determined. Visually, nodules with hydradenitis are similar to or tuberculous tubercle. The difference from a boil is the absence of a necrotic rod.

The tuberculous tubercle does not bring pronounced pain to a man, and also if there are lesions of the lymph nodes before the formation of tubercles.

Examination plan for a patient with hidradenitis:

. Leukocytosis is determined with a shift of the leukocyte formula to the left, an increase in ESR.
. It is performed to exclude infections of the urinary system, which may occur due to the ingress of the pathogen from the nodule into the urethra.
Blood chemistry. Dysproteinemia is determined, an increase in the level of C-reactive protein.
. It is prescribed to patients whose disease has become chronic.
Sowing from the detachable nodule to identify the pathogen. In parallel, an analysis is carried out for the sensitivity of microflora to antibiotics.

When confirming the diagnosis - hydradenitis in an intimate place, treatment should be prescribed immediately.

Treatment

Tetracycline;
Terramycin;
Erythromycin;
Levomikol.

Before prescribing an antibiotic, it is necessary to determine the sensitivity of the microflora and, based on the results of the analysis, the most active one is used. In a chronic course, it is possible to prescribe antibiotics in the form of injections (cephalosporins, penicillins, macrolides). Together with antibiotics, biological stimulants (methyluracil or pentoxyl) are prescribed.

In the case of a diagnosis of hidradenitis in a man, treatment with Vishnevsky ointment is possible after opening the nodules. Compresses are applied to the scrotum. A small amount of ointment is applied to cotton wool, applied to the knot and sealed with a plaster. Such a compress must be kept for 12 hours, after which a new one is applied.

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

An autopsy is performed in a sterile hospital environment, under anesthesia and if indicated:

Multiple nodules;
Abscessing of hidradenitis;
risk of complications.

Also, for the treatment of chronic hidradenitis, immunotherapy is used with a staphylococcal toxoid or vaccine. Effective is staphylococcal gamma globulin. Blood transfusion is used to reduce the likelihood of recurrence.

With hydradenitis of the scrotum, physiotherapy is used. UHF, UFL are used locally on the scrotum area. The modern method is X-ray therapy for hydradenitis.

To prevent the development of complications and the transition of the disease to the chronic form of hidradenitis, treatment with folk remedies is completely contraindicated.

Hidradenitis (mcb 10 L73.2 purulent hydradenitis) is an inflammation of the sweat glands, which most often occurs in the groin or under the arm. Also, this disease can affect areas of the skin that are localized:

around the anus;
near the nipples;
on the labia in women;
near the navel;
on the scalp;
on the scrotum in men.

In the people, hydradenitis is called a bough udder. This disease occurs with equal probability in both men and women. Hidradenitis does not affect the elderly, because the activity of the sweat glands is inhibited with age. Most often, the disease manifests itself in the summer, when the air temperature is high enough, and the person sweats a lot.

Stages of hydradenitis:
stage of infiltration;

stage of suppuration;

an abscess has formed and may rupture.

Inflammation of the sweat glands with hydradenitis is most often provoked by the activity of streptococci, staphylococci and other bacteria. They enter the body through excretory ducts on the skin.

Classification of hydradenitis:
purulent hydradenitis;

axillary hydradenitis;

inguinal hydradenitis;

chronic hydradenitis;

suppurative hydradenitis.

Causes of hydradenitis

The main reasons for the development of hidradenitis, regardless of the location of inflammation:

decrease in body resistance;
hyperactivity of sweat glands;
frequent injury to the skin;
disregard for personal hygiene;
as a consequence of dermatoses, which are accompanied by severe itching;
immunosuppressive states;
diabetes.

The causes of hydradenitis under the arm are non-compliance with personal hygiene, the formation of microtraumas and cuts from a razor. The provoking factor may be the use of low-quality depilatory products. Deodorant can also cause hydradenitis if used very often.

Purulent hydradenitis - causes

The causes of hidradenitis, which is accompanied by the accumulation of pus inside the sweat gland, are considered to be non-compliance with hygiene rules and untimely treatment of this disease. If, when a small swelling appears, you do not pay attention to it, over time, the skin in this place begins to become more inflamed. The resulting pimple grows rapidly in size and can reach 15-20 mm in diameter.

Gradually, the swelling softens, and pus begins to flow from its center. When the hydradenitis is opened, there are strong pain sensations, as an open wound is formed. This process can take 7-10 days. With proper treatment of hidradenitis, after opening the formation, a scar forms in its place.

Hydradenitis - the initial stage

At the initial stage of hydradenitis, some discomfort and tingling are felt under the armpit or in the groin. If you examine the skin, you can clearly see a small red pimple. In the initial stage of the disease, only one sweat gland is affected, and as hydradenitis develops, adjacent ducts may become inflamed.

This problem is characterized by the accumulation of secretion in the skin pore or near the hair follicle. Under these conditions, which are quite favorable for various bacteria, an inflammatory process develops.

Recurrent hydradenitis

Chronic or recurrent hydradenitis is characterized by the appearance of extensive inflammation of the sweat glands, which lasts for a long time. This form of the disease is considered the most difficult. It requires careful diagnosis and treatment. It is important to identify the causes that provoked such a long inflammatory process in the body.

Abscess is a frequent complication of recurrent hidradenitis, which can appear without timely complex treatment.

Suppurative hydradenitis

Suppurative hydradenitis of the armpit or other area of the skin appears due to blockage and rupture of the hair follicle. The disease is characterized by the formation of an inflammatory process that affects the sweat glands.

Another name for this form of hydradenitis is acne inversion. This disease affects a person after puberty. Its feature is the combination of inflammation of the sweat glands with various forms of acne. Hidradenitis can sometimes appear on the face or neck.

The causes of this skin condition are considered to be wearing uncomfortable clothing that rubs the skin. Also a provoking factor is obesity and increased sweating.

Hydradenitis in the groin

Hydradenitis in the groin area arises from tight and uncomfortable underwear that can rub. Microtraumas and diaper rash that form on the skin become the entrance gate for infection. Hydradenitis in an intimate place may appear from the frequent use of razors. Also, non-compliance with the rules of personal hygiene is directly related to this disease.

Hidradenitis in the groin in women appears in places where the apocrine glands are localized. It is characterized by the formation of dense nodes that cause pain.

Hydradenitis on the labia is accompanied by the formation of small formations protruding above the skin. Over time, they begin to increase in size and reach a diameter of 1-2 cm. At the same time, the problem area of the skin acquires a bluish tint. Hydradenitis on the labia is diagnosed by a gynecologist after conducting appropriate tests. This disease is characterized by simultaneous damage to several sweat glands.

When diagnosing hidradenitis in the groin, treatment should be started immediately. If nothing is done after a while, the subcutaneous fatty tissue is affected.

Hydradenitis in men can be manifested by the appearance of painful seals on the scrotum.

Hydradenitis under the arm

Axillary hydradenitis in the stage of infiltration is accompanied by inflammation of the sweat glands, mainly on one side. In this case, small dense nodules are formed, which, when palpated, cause a painful sensation. Over time, the discomfort increases as the formations increase in size and begin to fester.

In some cases, hydradenitis of the mammary gland can be observed. In this case, nodules appear near the nipples. Especially dangerous is hydradenitis during pregnancy or hydradenitis during breastfeeding. This condition without effective treatment can harm not only the mother, but also the child. The inflammatory process in a woman's body can cause other more dangerous conditions.

Which doctor should I contact with hydradenitis?

Hidradenitis is a rather dangerous disease, since in severe cases it can cause sepsis. Therefore, when identifying the first symptoms, you need to contact a dermatologist who will conduct an examination and prescribe adequate treatment. In most cases, antibiotics are used, which are detrimental to pathogenic bacteria.

If hidradenitis has passed to the stage of suppuration, its treatment can only be performed surgically. In this case, you need to contact a regular surgeon.

When hydradenitis appears in children, it is imperative to contact a pediatrician who will examine the baby and prescribe a specific treatment. It is also important to exclude other diseases that are characterized by similar symptoms.

Also note that hydradenitis is not contagious. The only exception is hair removal products, which can only be used by one person.

Symptoms

The clinical picture of hidradenitis, as a rule, unfolds with a certain dynamics and is characterized by the similarity of symptoms in different people. It is very important to note that if any of the symptoms described below appear, a person should immediately contact a medical institution for professional medical care.

The clinical picture of hydradenitis

Hidradenitis predominantly affects the sweat glands of one armpit and is considered unilateral. This is one of the features of the manifestation of the clinical picture.

In the initial stage of the development of the disease (stage of infiltration), the appearance of dense nodules of small diameter is observed in the skin, which can be easily felt under the skin. At the same time, their appearance is accompanied by a feeling of itching and slight pain, which increases with pressure on the nodules. The skin over the altered sweat glands becomes hyperemic. There is pain in the armpit when moving the hand.

The nodules grow rapidly and reach a diameter of up to 1.5 - 2 cm, solder with the skin and with each other. They can be seen on the skin in the form of pear-shaped tubercles with a considerable height. At the same time, outwardly they resemble the nipples of a dog, which is reflected in the trivial name of the disease - “bitch's udder”. The skin above them becomes purple-red, edematous and acquires a shine, which is associated with its tension. Soreness increases and now manifests itself not only with movements of the limb or pressure on the nodules, but also at rest. With further progression of hidradenitis, the nodules merge with each other and form large painful conglomerates, outwardly creating the illusion of a general inflammation of the subcutaneous tissue, which can make it difficult to differentiate the disease. This stage of the development of the disease is called the stage of maturation of hydradenitis, and, in addition to local symptoms, it is manifested by an increase in body temperature, general weakness, stiffness and soreness of the muscles, headache and other symptoms of malaise.

If left untreated, the disease progresses. Purulent inflammation begins in the subcutaneous nodules, which is accompanied by their melting and the release of pus from under the skin. At the same time, the pus is thick (similar in consistency to sour cream) and very often contains bloody impurities. At this stage of the development of the disease, the skin at the site of the lesion becomes soft to the touch, of a doughy consistency, which is associated with the presence of purulent foci under it. At this stage of the development of hidradenitis, it must be differentiated from the furuncle of the axillary region, this can be helped by the fact that there is no purulent core, which is observed in 100% of cases with the latter disease. After opening the festering node, the patient's condition improves: the temperature decreases and the symptoms of intoxication disappear. Visually, ulcers are formed at the site of the former nodes, characterized by a long healing process. After them, a retracted scar remains on the skin.

With the progression of the disease, regional axillary lymph nodes are involved in the process, which is manifested by symptoms of lymphadenitis: an increase and soreness of the lymph nodes, the inability to make limb movements due to pain.

As a rule, the development cycle of hidradenitis is two weeks, but at the same time, fresh purulent foci can be added to the already scarring nodes, which makes the disease potentially long and dangerous to human health. In this case, hidradenitis takes a chronic course with frequent and severe relapses, which requires a certain correction of treatment. With such a protracted course, comedones remain on the skin (fistulous passages connected to the surface of the skin by many holes).

Symptoms of complications of hidradenitis

With further progression of hidradenitis, it is possible to melt the tissues surrounding the sweat glands, which can manifest itself with a wide variety of symptoms, depending on the affected structure. Very often, the disease acquires a diffuse character and is accompanied by the development of phlegmon (unlimited purulent inflammation), which is clinically accompanied by the development of a severe intoxication syndrome (temperature rise to 40 ° C, headache, weakness) and the inability to make any movements of the affected upper limb. Another typical complication of hidradenitis is damage to the trunks of the brachial plexus, which is manifested by pain in the limb, a burning sensation along the nerves, and muscle weakness. The development of complications requires immediate hospitalization and the start of intensive treatment in a hospital.

It is very important to pay great attention to the prevention of hidradenitis and prevent the development of this disease.

Diagnostics

A doctor can prescribe treatment for any disease only after a visual examination, the patient undergoing additional instrumental examinations and obtaining the results of laboratory tests. With a pathology such as hydradenitis, the diagnosis includes the following parameters:

general blood analysis;
sowing discharge;
immunogram.

An important factor is the differential diagnosis of the disease. While the clinical manifestations seem obvious to the patient, and he is in a hurry to begin treatment; an experienced qualified specialist will scrupulously study the data presented so as not to confuse hydradenitis with such pathologies as

tuberculosis of the lymph nodes of the armpit;
furunculosis;
carbuncle;
abscess;
phlegmon;
lymphadenitis.

If there are clear signs that indicate that hydradenitis is developing, diagnosis should be carried out in a medical institution. The attending physician will write out a referral for the necessary studies and prescribe a competent treatment.

Laboratory and instrumental research methods for hydradenitis

It must be remembered that the doctor signs not only the treatment plan, but also the types of diagnostics. The patient cannot choose the preferred research methods, add certain items or refuse to undergo examinations. As mentioned above, many diseases are manifested by symptoms similar to those of hidradenitis. But similar manifestations do not mean that the treatment will be similar. Therefore, incorrect diagnosis of pathology, at best, will lead to a protracted course of the disease, and at worst, to the development of numerous complications. In order to accurately diagnose hidradenitis, five main examination methods are used.

The study of the clinical picture of the disease. This point should be treated with particular care. External manifestations can both push for the correct diagnosis with obvious manifestations, and confuse the blurring of symptoms. On examination, the doctor will reveal a bluish-red hue and swelling of the skin of the affected area, and on palpation, dense painful formations in the form of nodes are determined. A distinctive feature of hidradenitis from other pathologies is the absence of a necrotic rod.

Assessment of the general condition of the patient's body. Patients may complain of a deterioration in well-being, lethargy, drowsiness, apathy towards the outside world, headaches and dizziness, and increased sweating. These signs are relative and can be a manifestation of many diseases. However, in a comprehensive examination, you should take into account all the details and pay attention to any little things.

General blood analysis. In the general blood test, signs of inflammation appear: an increase in the erythrocyte sedimentation rate and an increased number of leukocytes.

Sowing discharge from the wound. Treatment of hidradenitis is not possible without antibiotic therapy. Therefore, it is advisable to culture the discharge from the wound to determine the sensitivity to these drugs. This measure will help to choose exactly the drug that will successfully eliminate the causative agent of the disease.

Immunogram. There are cases when prolonged and chronic hydradenitis is observed, the diagnosis in such a situation is supplemented by a study of the body's defenses. If the assumption about the weakening of the immune system is confirmed, the treatment is expanded by the introduction of immunomodulators.

Timely and high-quality diagnosis is an important step towards correct and adequate treatment.

Treatment

The method of treatment of hidradenitis depends on the stage of the disease. With the manifestation of a slight swelling, which has not yet had time to fester, you can get rid of the problem quite easily at home using external agents - antibiotic ointments and antiseptic solutions.

At an early stage of the disease, treatment with folk remedies is allowed, which is aimed at reducing inflammation and destroying pathogenic microorganisms on the skin. Also, various methods of physiotherapy show a positive result.

Effective treatment for hidradenitis includes antibacterial therapy with antibiotics. Immunostimulating agents are also indicated, especially if relapses of the disease occur.

If the formations on the skin are festering, you can not do without surgical intervention. Does it hurt to cut hidradenitis? No, because this operation is performed under local or general anesthesia, depending on the degree of skin damage. After removal of hidradenitis, it is important to follow all the recommendations of the surgeon and dermatologist in order to prevent repeated outbreaks of the disease. Also, for better healing of an open wound after surgery, local external therapy is indicated.

Can hydradenitis resolve? Of course, yes, if the treatment occurs in a timely manner and the correct drugs are used, which must be prescribed by a doctor.

How to get rid of hydradenitis at the initial stage?

How to treat hydradenitis under the arm or on any other part of the body, if only small seals have formed on the skin:

antibiotic therapy - used for 8-10 days, depending on the patient's condition;
antihistamines - used in case of severe itching;
immunostimulating agents that are aimed at normalizing the protective functions of the body;
specific immunotherapy - in cases of frequent relapses of the disease, when staphylococcus aureus is the cause of inflammation;
corticosteroids - are used in the form of injections that reduce the inflammatory process;
external use of antiseptic and anti-inflammatory solutions;
physiotherapy and dry compresses.

If you follow the instructions of doctors and use an integrated approach to solving the problem, hydradenitis resolves within 10-14 days.

How to treat hidradenitis - personal hygiene and skin care

How to cure hidradenitis quickly and without surgery? To do this, you need not only to take the drugs prescribed by the doctor, but also to follow the rules of personal hygiene with special care and take care of the inflamed areas of the skin.

First of all, cut off the hairs that are near the swelling with nail scissors. Also wipe the skin with antiseptics 4-5 times a day to prevent the spread of infection to neighboring sweat glands. If large areas of the skin are affected, ointments or injections with antibiotics and painkillers are prescribed.

The first days after the appearance of swelling, put gauze bandages on them, which must be soaked with antiseptics. Top can not be sealed with a plaster, which can create a greenhouse effect and worsen the situation. The use of wet compresses is also prohibited. This will only accelerate the suppuration of neoplasms.

Treatment of hydradenitis under the arm is best supplemented with dry compresses. To do this, apply a warm cloth to the affected areas of the skin or expose your hand to direct sunlight for 20-30 minutes daily.

During an outbreak of hidradenitis, it is not recommended to take a bath, which can lead to the spread of the disease to other areas of the skin. It is best to wash under the shower. At the same time, glue a bactericidal patch on the inflamed swelling. Also, during treatment, refuse to shave, so as not to provoke new outbreaks of the disease in other areas of the skin and not slow down the healing process.

Purulent hidradenitis - treatment

With the development of suppuration in places with swelling, all treatment comes down to the use of various means that will help it mature, after which hydradenitis is opened. To do this, it is best to use special ointments that are applied in a thick layer to the skin. This must be done until the moment when the abscess opens.

In parallel with external agents, it is necessary to continue the use of antibiotics, immunomodulatory drugs prescribed by the doctor.

When pus discharge appears in the middle of the seal, it is imperative to contact a surgeon who will remove the hydradenitis. You cannot open an abscess on your own. This can cause infection of the blood, which will lead to serious consequences.

Hidradenitis - surgical treatment

Surgery for hydradenitis is a necessary measure that will help eliminate abscesses and prevent the spread of the disease to other areas of the skin.

Depending on the nature of the disease, surgical intervention can take place according to the following schemes:

the appearance of one abscess for the first time - the operation takes place under local anesthesia, and lasts no more than 30 minutes. The surgeon opens the abscess, removes all the pus, and then treats the wound with antiseptics and antibiotic solutions;
the formation of hydradenitis several times in the same place - during the operation, the entire inflamed sweat gland is removed;
hidradenitis, which is accompanied by the formation of a large number of abscesses - the operation takes place in two stages under general anesthesia. This procedure is indicated in the most severe cases, which requires a long recovery period and strictly follow all the doctor's recommendations.

Treatment of hidradenitis in an intimate place, including surgery, occurs according to the same scheme that is used for other localization of abscesses.

Physiotherapy for hydradenitis

Together with other methods of treating hidradenitis, physiotherapy is used, which includes:

UHF therapy - helps to reduce the inflammatory process and eliminate the abscess;
UV therapy - destroys bacteria on the skin and increases resistance to infections;
CMW therapy - improves blood microcirculation and eliminates inflammation;
x-ray therapy - used to destroy the sweat gland, which is constantly inflamed.

Prevention of hidradenitis

An important point is the careful observance of hygiene standards:

wear clothes made from natural fabrics, which should be loose and not rub anywhere;
do not use daily antiperspirants. It is best to choose a powder with a bactericidal effect for yourself;
change clothes and underwear every day, especially in summer;
try not to shave with a razor. It is preferable to use laser hair removal or cut hairs short;
take a shower daily;
once a week for hygiene procedures, use antibacterial soap;
for intimate hygiene, use special gels that contain lactic acid.

In order to prevent the formation of abscesses and inflammations that are characteristic of hydradenitis, it is necessary to systematically strengthen the immune system, monitor weight and treat other infectious diseases in a timely manner.

Medications

The choice of means and methods for the treatment of hidradenitis largely depends on the stage of the disease and the nature of its course. So, in the early stages of the disease, dermatologists often prescribe medication to their patients.

Surgical intervention is carried out only if the treatment of hydradenitis with ointments and tablets for a long time has not brought any results.

As a rule, a conservative technique consists in the treatment of hidradenitis with antibiotics. They can be used both internally and externally in the form of various ointments, creams, sprays, etc. However, in whatever form the medicine is, only a doctor can prescribe it. This is due to the fact that antibiotics for hydradenitis can be addictive, which in the future may adversely affect the effectiveness of therapy.

Good results in the treatment of the disease are also shown by ointments that have the ability to draw purulent contents out.

However, any medication should be prescribed by a specialist in the appropriate field. Only he knows which antibiotics for hydradenitis and ointments should be prescribed to a particular patient.

Vishnevsky ointment

Physicians are ambiguous about the use of Vishnevsky's ointment, because sometimes it speeds up the process of producing pus.

The composition of this tool contains tar, camphor and castor oil. These components of the drug have a slight irritating and warming ability.

After applying the product to the affected area, it warms up, and the blood supply in it improves. All this leads to the rapid development of the inflammatory process.

This means that Vishnevsky's ointment for hydradenitis is prescribed only if the pathology has already passed into the suppuration phase. In this situation, the essence of its application is to accelerate the process of opening the abscess. That is, ointment from hidradenitis is used not to suppress, but to enhance the inflammatory process.

However, in the initial stages of the disease, this medicine is still not advisable to use. That is why it is so important that Vishnevsky's ointment for hydradenitis is prescribed by a specialist.

A contraindication to the use of the drug is an allergy to the components of the drug.

Ichthyol ointment

Ichthyol ointment is another effective remedy for hydradenitis. It, like Vishnevsky's ointment, speeds up the opening process.

The agent showed the greatest effectiveness in the treatment of sluggish hidradenitis, in which the inflammatory process is weak, but at the same time prolonged. As a rule, ichthyol ointment for hydradenitis is prescribed in combination with antibacterial drugs for oral administration.

Among the contraindications to the use of this medication, hypersensitivity to the components of the drug, pregnancy and lactation, age under 12 years old can be noted.

Levomekol

Levomekol is an ointment that has antibacterial, regenerating and anti-inflammatory effects. It contains levomethicin (an antibiotic) and methyluracil. It is worth noting that in case of a severe course of the disease, the doctor may prescribe the administration of chloramphenicol in tablet form inside.

Since Levomekol is a drug based on several drugs, it can replace several drugs accordingly.

Levomecithin contained in the drug has a detrimental effect on staphylococci, streptococci, Escherichia coli and many other bacteria. At the same time, methyluracil accelerates the process of tissue regeneration. In addition, it effectively simulates local immunity, so that the body eliminates the infection faster.

For the same reason, Levomekol is able to fight not only bacterial, but also viral infections.

Levomekol with hydradenitis is a relatively safe ointment. A contraindication to its use is only the presence of an allergic reaction to the constituent agents.

However, only a doctor should prescribe the ointment, since in some cases it can cause side effects, among which swelling, rash, itching and redness of the skin can be distinguished.

If these symptoms occur, the patient should consult a doctor as soon as possible. When the drug is replaced, side effects disappear within a few days.

Erythromycin

Erythromycin for hydradenitis can be administered in various forms, both in tablets and in the form of an ointment. The choice of the form of the remedy and the scheme of its use in this case is carried out by the doctor, based on the degree of the disease and the nature of its course.

This antibiotic can affect both Gram-positive and Gram-negative bacteria. Unlike antibiotics of the penicillin group, erythromycin ointment for hydradenitis is much easier to tolerate by patients.

Erythromycin stops protein synthesis by pathogenic microorganisms, which leads to their death and a decrease in the inflammatory process.

Unfortunately, erythromycin (in any form), like most drugs, has its own contraindications. So, this tool is not recommended to use if the patient has intolerance to the components of the drug or severe liver disease. Pregnant women and children should consult a doctor before using the drug.

Among the side effects of the drug, patients sometimes note dizziness, swelling, migraines and difficulty breathing.

Dimexide

Dimexide is a drug for external use that has anti-inflammatory, antibacterial and mild analgesic effects.

Dimexide has a low price, and you can buy it at any pharmacy.

Its main function is to conduct other drugs into the deeper layers of tissues, that is, it acts as a conductor.

However, you can use this tool only as directed by a doctor, since if used incorrectly, it can cause a chemical burn or carry into the body along with beneficial substances and toxic ones.

Pregnant women and patients with liver and kidney diseases should refrain from using dimexide for hydradenitis.

Among the side effects of the drug, patients often note nausea, allergic reactions, respiratory disorders and burning sensation.

As a rule, the doctor selects for the patient individually the medications that must be used with Dimexide to achieve the best results. To do this, the patient must independently make various talkers and ointments with dimexide in the composition. It is important not to self-medicate. Only a doctor knows exactly how to smear hydradenitis to his patient.

Amoxicillin

Amoxicillin is an oral antibiotic. It effectively fights pathogenic bacteria - causative agents of hydradenitis.

Its absorption in the stomach occurs within 15-30 minutes after ingestion. It reaches its maximum activity after 2 hours, and the duration of its action is 8 hours.

Among the side effects of amoxicillin are allergies, digestive disorders, and central nervous system damage.

Folk remedies

In addition to the official approach in the treatment of hydradenitis, traditional medicine is also effective. But at the same time, it is worth remembering that this inflammatory process is a serious ailment, so the selection of a folk remedy should be carried out after consulting a doctor.

Aloe disinfection

Treatment of hidradenitis at home is effective when using the leaves of this houseplant.

For the procedure, perennial aloe is used, which must be washed with water before use, the thorns are removed. A cut sheet is applied to the site of inflammation for 20 minutes several times a day. The medicinal juice of the plant draws out pus and promotes the rapid healing of inflammation.

Compresses from blackberry leaves, plantain and white cabbage are also suitable for cleansing an abscess.

Treatment with onions

With purulent rashes, baked onions are effective. The vegetable is cut into half rings and baked in the oven until golden brown. Then the agent is applied to the sore spot, fixed with sterile cotton and bandaged.

Treatment must be continued until the rupture of the abscess.

Honey and propolis

Alternative treatment of hydradenitis involves the use of honey and propolis in the absence of allergies.

If there are no special contraindications, then bee glue and honey are mixed, and there should be a little more propolis in the therapeutic composition. Wheat flour is added to the folk remedy. The resulting cake must be applied to the diseased area, secured with adhesive tape.

Sour cream and rye flour

For a compress with hydradenitis, fatty sour cream and flour are used. The resulting mass should be dense, it is important that the substance does not slip from the place of attachment.

Eggs, honey and flour are also used for the compress. All components are mixed into a homogeneous composition and applied for several hours to the site of inflammation.

To fix the flour cake, you also need an adhesive plaster.

Herbal remedies

For a complete cure for the disease, it is effective to take medicines inside. In this case, phytotherapy comes to the rescue.

Calendula tincture is also suitable for treating an inflamed area. A little water is added to the solution before use.

To accelerate the maturation of the abscess, an infusion of wormwood paniculata is used. The boiled product cools, the diseased areas are lubricated with medicine.

With hydradenitis, a herbal collection of eucalyptus and plantain leaves, calendula and elderberry flowers is effective. All plants are taken in equal proportions. One glass of raw materials is crushed and poured with water, the mixture is brought to a boil over low heat.

The medicine is used several times a day after insisting in a dark place. For taste, you can add a teaspoon of honey to the broth. This folk remedy for hydradenitis has anti-inflammatory properties and improves immunity.

To heal a burst abscess

To make the wound heal faster, wash the sore spot with infusion of chamomile or sage. This will not only reduce inflammation, but also relieve pain.

It is strictly contraindicated to squeeze out an abscess. This can lead not only to redness and expansion of the inflammatory area, but also to blood poisoning (sepsis). This condition is life-threatening and requires urgent hospitalization.

Although folk remedies have a certain therapeutic effect, a conservative approach is not a panacea for hydradenitis. With inflammation, surgical intervention is often indicated, so you cannot prescribe treatment yourself. Running the disease is also not an option, since hydradenitis can go into the stage of severe suppuration.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Hydradenitis is a rather unpleasant disease and, according to statistics, is more often observed in women. The prevalence of this pathology is unknown, but it is noted that young people suffer from hidradenitis (from puberty to 45 years).

The disease never occurs in children and the elderly, which is associated with the peculiarities of the functioning of the skin (sweat glands) during these age periods. In childhood, the apocrine (sweat) glands have not yet begun to function, and in old age their function fades. People of various nationalities can suffer from the disease, but it occurs several times more often in people of the Negroid race.

The term "hydradenitis", types of disease

Hydradenitis is an inflammatory process accompanied by suppuration of the apocrine sweat glands and caused by the penetration of an infection into them, usually staphylococcal. The armpits are most often affected (hydradenitis under the arm), but inflammation of the apocrine glands near the navel, in the inguinal folds, around the anus, scrotum and large pudendal lips is possible.

The course of the pathology is gradual, at first the affected sweat gland increases in size (no more than a pea), thickens and becomes painful. Within a week, the inflammatory process progresses, suppurates, the gland increases to 3 centimeters in diameter and becomes pear-shaped. Outwardly, such changes very much resemble a nipple, and therefore hydradenitis is popularly called "bitch's udder".

Rare localizations of the disease include cases of inflammation of the apocrine glands of the peripapillary region and the scalp.

Classification

There are the following types of pathology:

Depending on the flow:

acute purulent hydradenitis;
chronic process.

Depending on location:

under the arm;
hydradenitis of the scrotum;
peripapillary region;
umbilical region;
perianal area;
inguinal hydradenitis and others.

Depending on the extent of coverage:

unilateral;
two way process.

Skin and skin glands: anatomy

The skin is the largest organ of the human body in terms of area and reaches two square meters in size. The skin is represented by three layers, and each performs its tasks:

Epidermis

This is the uppermost (outer layer) of the skin, its thickness is 0.1 - 1.5 mm. In turn, the epidermis includes 5 layers. In the underlying layers, cells are renewed, which replace the old cells in the upper layers of the epidermis and ensure the healing of minor skin injuries (abrasions, scratches). The upper layer is represented by keratinized and keratinized (dead) cells. The function of the upper layer of the epidermis is to mechanically protect the skin and prevent the penetration of infectious agents into the deeper layers of the skin. The entire thickness of the epidermis is penetrated by the ducts of the skin glands.

Dermis

Another name for the dermis is the skin itself, which is represented by connective tissue. The dermis has a two-layer composition:

papillary layer

Located just below the epidermis. In the outgrowths of the papillary layer are nerve endings and capillaries.

mesh layer

In addition to the blood and lymphatic vessels and nerve endings passing between the connective tissue cells, hair follicles, sebaceous, sweat glands are located in the thickness of the mesh layer. In addition, in the papillary layer there are fibers of collagen and muscle tissue, which give the skin turgor (elasticity and firmness).

Subcutaneous adipose tissue

This is the lowest layer of the skin, which is represented by accumulations of fat cells located between bundles of connective tissue. Its function is to provide additional protection of the body from damage, temperature changes and the creation of a depot of nutrients (fat reserves).

The skin has appendages, which include nails and hair, as well as glands.

skin glands

Skin glands are of two types: sebaceous and sweat. The task of the sebaceous glands is the production of sebum. Due to the fatty substance, a protective layer is formed on the surface of the skin, which prevents the penetration of liquid deep into the skin (and bacteria can enter the thickness of the skin with water). The sebaceous glands are located superficially and the mouths open into the hair follicles. Every day, these glands produce about 20 grams of fat.

Sweat glands, as the name implies, are responsible for the secretion of sweat. Their structure is tubular, and the lower part (secreting) is represented by a tube folded into a ball and is located in the thickness of the dermis. Through the excretory ducts, sweat goes out or into the mouths of the hair follicles. Every day (average ambient temperature) is produced about 800 ml of sweat with 40 grams of salt in it.

In turn, the sweat glands are divided into:

eccrine

They are located on the entire area of the skin, but mostly on the palmar surfaces, feet and forehead. They produce transparent sweat, the composition of which is represented by water (99%) and a small amount of lactic acid, due to which the sweat gives the skin a slightly acidic reaction. The function of the eccrine sweat glands is to reduce body temperature when the body overheats due to the evaporation of fluid.

Apocrine

The localization of apocrine sweat glands is well defined. They are located in the armpits, around the nipples and navel, in the inguinal folds and near the anus. Of the total number of sweat glands, apocrine glands make up 10–30%. The sweat that these glands secrete is thicker and has a whitish tint due to fats and cholesterol. The secret of the apocrine glands has a strong, pungent odor, since the tops of the cells of these glands are destroyed and are part of the sweat.

The sweat of the apocrine glands is an excellent breeding ground for bacteria, and their reproduction and subsequent death only exacerbates the unpleasant odor. The load on the apocrine glands increases with overheating of the body or stress. In addition, these glands are activated in women during menstruation.

And if the sweat of the eccrine glands has an acidic reaction and protects the skin from the colonization of pathogenic microbes, then the sweat of the apocrine glands is either neutral or has an alkaline reaction, which is favorable for the reproduction of bacteria. This feature explains the development of hidradenitis exclusively in the apocrine sweat glands. Moreover, the ducts of the apocrine glands are much wider than the eccrine glands, which explains the easy penetration of microbes into the thickness of the glands.

Causes of hydradenitis

For the development of the disease, 3 conditions are necessary:

pathogenic microorganism (usually staphylococcus, but streptococci and E. coli are not excluded);
weakened local skin protection;
suppressed general immunity.

The causative agent of the disease

The most common cause of hidradenitis is staphylococcus aureus. Staphylococci are very common bacteria and are divided into several varieties. Some staphylococci are practically not dangerous, while others can provoke severe purulent diseases and even death:

Epidermal staphylococcus aureus

It is part of the normal microflora of the human skin and belongs to conditionally pathogenic bacteria. That is, when immunity is weakened, this form of microbes becomes pathogenic and provokes the development of pustular skin diseases.

Saprophytic staphylococcus aureus

It also colonizes human skin normally and does not pose a health hazard, except for people with suppressed immunity.

Staphylococcus aureus

The most dangerous microorganism not only among other staphylococci, but also among all bacteria in general. Thanks to Staphylococcus aureus, tonsillitis, pneumonia and sepsis occur.

About 20% of the population are healthy carriers of this infection, but they can provoke various purulent diseases in their close environment, since most people are very sensitive to Staphylococcus aureus. This type of bacteria is highly contagious and virulent (contagious).

When bacteria get on the skin, furunculosis, phlegmon, hydradenitis develop, and when they penetrate into the blood, sepsis, inflammation of the small intestine, pericarditis. A special danger to Staphylococcus aureus is added by the toxins it secretes, which destroy the cells of the body, including blood cells (erythrocytes and leukocytes).

Condition of the skin

skin pH

Normally, the skin has a slightly acidic reaction, in the range of 4 - 5.6. Such a reaction is created by sweat with weak acids containing them: lactic and others. Due to the acidic environment, a normal microbiocenosis of the skin is maintained, that is, saprophytes (safe bacteria for the skin) multiply, preventing the colonization of pathogenic microbes. But the acidity of the skin is not constant, and can change under the influence of various factors (alkaline products for skin care and hygiene, the use of baking soda inside or outside for cosmetic purposes). In this case, the skin environment becomes alkaline, which is favorable for the reproduction of pathogenic microorganisms and the development of pustular skin diseases, including hidradenitis.

sweating

Healthy skin is characterized by moderate perspiration. Sweat removes toxins and salts from the skin, thereby cleansing them. But with increased work of the apocrine sweat glands, their excretory ducts are squeezed by the "inflated" secretory part of the glands. As a result, sweat is not released, but accumulates in the glomeruli of the glands, where microbes begin to actively multiply.

Increased secretion of apocrine glands can cause: high ambient temperature (heat), fever, stress, hormonal changes.

Hormonal imbalance

The content of hormones in the body also affects the condition of the skin. For example, increased sweating and increased secretion of sebum causes an increase in testosterone, especially during puberty. In addition, blood glucose rises, which leads to a decrease in the formation of lymphocytes (immune cells). As a result, the local immunity of the skin is weakened, and, as a result, the sweat glands become inflamed.

Hormonal shifts can also be caused by polycystic ovaries, inflammation of the organs of the reproductive system, puberty, pregnancy and menopause.

Puberty

Children do not get hidradenitis because their apocrine sweat glands have not yet begun to function. But with the onset of puberty, these glands become active and begin to produce sweat in large quantities, especially in the axillary and groin areas. The reaction of the skin in these areas becomes alkaline, which predisposes to the development of hydradenitis.

allergic skin reactions

Under the influence of allergens on the skin, histamine begins to be produced, which activates immune cells. Immune cells, in turn, "attack" skin cells, causing its self-damage: increased skin temperature, swelling, hyperemia, itching. The main skin functions begin to suffer, which is only "on hand" for pathogenic bacteria, they actively penetrate into the thickness of the skin, causing a purulent inflammatory process. Allergies are provoked by cosmetics and detergents, medicines and vitamins, some foods (nuts, chocolate, citrus fruits).

diaper rash

Diaper rash is formed in the skin folds, where there is increased sweating, air does not enter and sweat does not evaporate. As a result, the skin is constantly moist and softened. When rubbing the skin in the folds, microtraumas occur, where microbes (fungi, viruses and bacteria) quickly settle. As a rule, diaper rash is characteristic of obese people (armpits, intergluteal and inguinal folds, under the mammary glands).

The following factors provoke the occurrence of hydradenitis:

neglect of the rules of personal hygiene;
hair removal and shaving (microtrauma);
frequent washing (more than once a day);
wearing synthetic or tight underwear (micro abrasions);
use of antiperspirants (blockage of sweat glands);
endocrine diseases (diabetes mellitus, pathology of the thyroid gland, adrenal glands and pituitary gland);
obesity;
violations of embryogenesis, when the wrong ducts of the apocrine glands are formed.

Immunity

Immune suppression occurs as a result of:

Depletion of the body:

high physical activity;
acute infectious diseases, poisoning;
sleep disturbance (chronic insomnia);
trauma/surgery;
massive blood loss or small but constant blood loss;
nervous tension/stress.

Chronic diseases:

tuberculosis;
herpetic infection;
viral hepatitis;
HIV infection;
toxoplasmosis;
helminthic invasion.

Taking medication:

cytostatics;
antibiotics;
glucocorticoids (prednisolone, dexamethasone).

Congenital immune pathology:

hereditary neutropenia;
X-linked agammaglobulinemia;
combined immunodeficiency.

Autoimmune diseases:

rheumatic lesions;
lupus erythematosus;
scleroderma.

Irrational nutrition:

mono-diets;
vegetarianism;
vitamin deficiency.

Age periods:

childhood;
old age;
pregnancy;
menopause.

Development mechanism

The duct of the sweat gland is clogged with a cork from the scales of the desquamated epithelium and the secretion of the gland. As a result, both the duct and the gland increase in size, as sweat has accumulated in them. Microorganisms begin to multiply in the gland, which leads to the development of inflammation. Then the gland ruptures and the infection spreads to surrounding tissues. The focus of inflammation is delimited by a connective tissue capsule, pus accumulates in it. After the opening of the purulent cavity, the outpouring of pus occurs, which leads to the deposition of fibrin on the walls of the cavity and the formation of fistulous passages.

Clinical picture

In its development, hydradenitis goes through several stages:

Infiltration stage

As a rule, the disease develops on one side, but bilateral lesions are also possible, for example, bilateral axillary hidradenitis. At the stage of infiltration, small dense nodules appear separately located from each other in the skin. Their appearance is accompanied by itching and slight soreness, which increases with pressure on the nodule. The size of the nodules varies from 2 - 3 millimeters to 1.5 - 2 cm. Reddening of the skin is noted at the site of the lesion.

ripening stage

As the disease progresses, the nodules begin to rapidly enlarge and coalesce. They protrude above the skin and look like nipples. The color of the skin at this stage becomes purple-cyanotic, there is severe pain not only during movement, but also at rest. The fusion of the nodules leads to the formation of a diffuse infiltrate, which has a dense texture and disc shape, therefore it is similar to the phlegmon clinic. The maturation stage is accompanied by a pronounced intoxication-inflammatory syndrome.

Stage of spontaneous opening

As the focus of inflammation matures, its central part gradually softens and hydradenitis opens. In the process of opening, pus is released in a significant amount, which looks like thick sour cream. The purulent discharge may contain blood impurities. To differentiate the disease, especially hydradenitis in the groin, follows from the boil. With suppuration of the hair follicle (furuncle), there is always a necrotic rod (hair). Spontaneously, hydradenitis opens approximately 7 to 10 days after the onset of development. As soon as the purulent focus has opened, the general condition of the patient improves, and the pain is significantly reduced.

Healing stage

After opening the abscess, a bleeding and festering ulcer forms at this place, which gradually heals. After healing, a retracted and rough scar is formed on the skin. The whole process from the onset of the pathology to the formation of a scar is about 14-16 days. The danger of hidradenitis is that, along with a cicatrizing ulcer, adjacent apocrine glands can inflame and suppurate in parallel (the process of inflammation does not bypass them either). In this case, they talk about a protracted or chronic relapsing course, which is accompanied by exacerbations of 10 or more times.

Interpretation of the symptoms of hydradenitis

It occurs due to circulatory disorders in the affected area, where fluid stagnation has appeared.

Swelling tissues pinch the nerve endings, which causes pain. The more swelling increases, the more intense the pain.

Color of the skin

Stagnation of blood leads to the accumulation of red blood cells in the capillaries, which first gives a reddish tint to the skin, and then, as the red blood cells are destroyed, the color changes to a bluish-purple.

Infiltrate

Around the purulent focus, white blood cells are concentrated - leukocytes, which are designed to fight pathogens. A massive accumulation of leukocytes leads to the formation of a dense and flat infiltrate. Leukocytes and lymph are not only in the skin, but also thicker than the subcutaneous fat, and the infiltrate can spread to the entire surface of the armpit.

Intoxication syndrome

High fever, fever followed by chills, lack or loss of appetite, nausea and vomiting, general weakness - all these signs are caused by toxins that Staphylococcus aureus produces.

Purulent cavity

Pathogenic microbes lead to tissue necrosis of the apocrine gland, the secreting part of it breaks and a cavity is formed in which pus is located (dead cells and bacteria, sweat processed by microbes).

Autopsy of hidradenitis

As pus accumulates in the focus of inflammation, pressure increases, which one of the walls of the cavity cannot withstand and an autopsy occurs with the outpouring of a large amount of creamy pus.

Treatment of hidradenitis

How to treat hydradenitis? The answer depends on the stage of inflammation and its severity. Therapy of the disease should be complex, and in the stage of maturation of the abscess, surgical intervention is performed.

Antibiotic therapy

With hydradenitis, antibiotics are mandatory. The selection of antibacterial drugs is carried out by the doctor, focusing on the results of the tests obtained and the type of isolated pathogenic microorganisms. Depending on the severity of the course of the disease, antibiotics are prescribed orally (by mouth) or intramuscularly. On average, the duration of the course of antibiotic therapy is 7-10 days, but it is possible to lengthen it or replace drugs if there is no effect from the treatment. Broad-spectrum antibiotics are used that are most effective against Staphylococcus aureus and Streptococcus aureus:

tetracyclines (doxycycline);
macrolide group (azithromycin or erythromycin);
a group of cephalosporins (kefzol, ceftriaxone);
fluoroquinolones (ciprolet);
penicillin group (amoxiclav).

Diet

Treatment of hidradenitis includes diet. Patients are recommended a complete and vitamin-enriched diet, the principles of which must be followed not only in the process of development and cure of the pathology, but also for another three months after recovery. It is strictly forbidden to use spicy dishes and seasonings, alcohol, pastries, smoked meats, sausages and confectionery (sweets, creams, mousses, marshmallows, chocolate) and indigestible fats (animals): lard and butter. The diet should be dominated by fresh fruits and vegetables, food should be steamed, boiled or baked. Also, the diet should contain fermented milk products to restore normal intestinal microflora, and replace animal fats with vegetable oils. Replace fatty meats and fish with lean ones, and include nuts and cereals (cereals) in the diet as a source of vitamin E (an antioxidant, accelerates healing) and fiber.

Treatment in the stage of infiltration

Treatment of hidradenitis in the stage of infiltration (the first three days) is carried out at home and involves, in addition to taking antibiotics, local therapy. Local treatment consists in treating the skin with alcohol solutions of antiseptics (iodine, brilliant green, camphor or salicylic alcohol, boric acid, chlorhexidine).

After each treatment of the focus of inflammation, wet-drying semi-alcoholic dressings are applied (dioxidine diluted with water and alcohol, alcoholic tincture of calendula with the addition of water, alcoholic solution of chlorphyllipt with the addition of water). As soon as the bandage has dried, it is moistened again with the prepared solution and the manipulation is repeated twice a day for 3 hours. From above, the bandage is not closed with anything to prevent the greenhouse effect.

It is strictly forbidden:

taking baths, visiting saunas and baths (hot air, high humidity and water aggravate the spread of infection):
shaving / hair removal in the lesion (additional injury to the skin and the spread of inflammation);
wearing tight clothing made of synthetic materials;
the use of compresses and dressings with ointments (cause weeping of the skin, increase infiltration and spread the infection).

wearing loose-fitting clothes made from natural fabrics;
daily shower, pre-close the lesion with a band-aid;
individual towel and bed linen, daily change;
treatment of the focus of inflammation after a shower with a solution of potassium permanganate;
drying of skin folds with powders (talc, zinc oxide);
dry heat to the site of inflammation (ironed towel, irradiation with a blue lamp for 5 minutes, sunbathing for 10-20 minutes, depending on the time of day and season).

Surgery

Surgical intervention is carried out when the disease passes into the stage of maturation, when it was not possible to stop the development of hidradenitis in a conservative way. To begin with, the “ripening” of the abscess is activated. For this purpose, ichthyol cakes about 3 mm thick are applied to the affected area, covering the medicine with a thick layer of cotton wool from above.

Thus, in the focus of inflammation, the temperature rises and the abscess "ripens", ready to break through. The lozenges should be applied twice a day. After suppuration of hidradenitis, the doctor dissects it with a wide and deep incision to the level of healthy tissues. The wound is washed with an antiseptic solution, then with an antibiotic and drained. The management of the postoperative wound is carried out in an open way, that is, no stitches are applied.

With a recurrent process, after opening the abscess and its healing, the second stage of the operation is performed. At this stage, the doctor excised the affected glands along with subcutaneous fat and skin. The resulting skin defect is produced with the patient's own skin flaps, for example, from the back.

Physiotherapy

In addition to antibiotics and surgery, physiotherapeutic procedures are actively used in the treatment of pathology.

In the infiltration stage are assigned:

SMT-phoresis;
UV therapy in the focus of inflammation.

After surgical treatment, to accelerate the regeneration processes, the following are used:

infrared irradiation;
laser therapy;
magnetotherapy;
ultrasound;
electrophoresis with drugs (unithiol, dionin).

Question answer

Which doctor treats hydradenitis?

If the process has not yet reached the stage of suppuration, that is, it is in the process of infiltration, the treatment is carried out by a dermatologist. With suppuration and the threat of opening the abscess, the surgeon is involved in the treatment.

Why is hydradenitis dangerous?

The disease, in the absence of timely and adequate treatment, threatens to turn into an abscess or phlegmon. In advanced cases, infectious agents penetrate into the general bloodstream, which is fraught with blood poisoning - sepsis.

Is it possible to use alternative methods of treatment for hydradenitis and which ones?

If you try to get rid of the disease only with the help of traditional medicine, then at best the abscess will “ripen” and open on its own, and at worst there will be severe purulent-septic complications. Alternative methods of treatment can be used for this pathology, but as an addition to the main treatment and the permission of the doctor. You can apply beaten leaves of plantain and celery, cut aloe leaves to the site of inflammation - all these plants have bactericidal properties. It is also allowed to treat the affected area with decoctions and infusions of herbs with antiseptic properties (chamomile, calendula, linden, sage, yarrow.

Is it necessary to go to the hospital with hydradenitis?

No, not necessarily. Only patients with a recurrent and chronic process requiring radical surgery are hospitalized, with a severe course of the disease and a severe general condition of the patient.

Is hydradenitis related to hereditary diseases?

There are no exact data on this issue, but it can be said that increased sweating (hyperhidrosis), obesity and other factors that predispose to the occurrence of hydradenitis are inherited.

Hydradenitis in the groin

How to treat this disease

Causes

Classification

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

Treatment of hidradenitis at home

Signs of hidradenitis in the groin

Symptoms

Diagnostics

Treatment

Treatment with folk remedies

The process of development of hidradenitis, complications and consequences

How can purulent hydradenitis (bitch udder) develop?

Prevention

Symptoms

Diagnostics

Treatment

Stages of hydradenitis: stage of infiltration; stage of suppuration; an abscess has formed and may rupture.

Classification of hydradenitis: purulent hydradenitis; axillary hydradenitis; inguinal hydradenitis; chronic hydradenitis; suppurative hydradenitis.

Causes of hydradenitis

Purulent hydradenitis - causes

Hydradenitis - the initial stage

Recurrent hydradenitis

Suppurative hydradenitis

Hydradenitis in the groin

Hydradenitis under the arm

Which doctor should I contact with hydradenitis?

Symptoms

The clinical picture of hydradenitis

Symptoms of complications of hidradenitis

Diagnostics

Laboratory and instrumental research methods for hydradenitis

Treatment

How to get rid of hydradenitis at the initial stage?

How to treat hidradenitis - personal hygiene and skin care

Purulent hidradenitis - treatment

Hidradenitis - surgical treatment

Physiotherapy for hydradenitis

Prevention of hidradenitis

Medications

Vishnevsky ointment

Ichthyol ointment

Levomekol

Erythromycin

Dimexide

Amoxicillin

Folk remedies

Aloe disinfection

Treatment with onions

Honey and propolis

Sour cream and rye flour

Herbal remedies

To heal a burst abscess

The term "hydradenitis", types of disease

Classification

Depending on the flow:

Depending on location:

Depending on the extent of coverage:

Skin and skin glands: anatomy

Epidermis

Dermis

Subcutaneous adipose tissue

skin glands

eccrine

Apocrine

Causes of hydradenitis

The causative agent of the disease

Epidermal staphylococcus aureus

Saprophytic staphylococcus aureus

Staphylococcus aureus

Condition of the skin

skin pH

sweating

Hormonal imbalance

Puberty

allergic skin reactions

diaper rash

The following factors provoke the occurrence of hydradenitis:

Immunity

Depletion of the body:

Stages of hydradenitis:
stage of infiltration;

stage of suppuration;

an abscess has formed and may rupture.

Classification of hydradenitis:
purulent hydradenitis;

axillary hydradenitis;

inguinal hydradenitis;

chronic hydradenitis;

suppurative hydradenitis.