What is hidradenitis suppurativa?

Question

Hi doctor,

I am a 41-year-old female. I am obese. My weight is 196.21 Ibs and my height is 5 feet 7 inches. Currently, I am taking Thyronorm 75 mcg and Storfib 145. Previously, I used to get lymph node enlargement in my underarms and groin areas, but they never become lesions. I have been having a pus oozing lesion on my underarm for the past 1.5 years. When I take antibiotics, it heals. But once I stop the medicine, it recurs. Earlier, I showed this lesion to a lady physician who suggested an ultrasound scan. The scan revealed a pocket of pus, but no changes in surrounding tissue. This lesion started when I changed my deodorant once. My 14-year-old son also has the same issue. He gets lesions in his underarms, which sometimes heal, and at other times pus leaks. I do not feel any thickness in my breasts in self-examination. I feel it is more dermatological. Please share your valuable opinion.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

You might be suffering from hidradenitis suppurativa, skin disease that causes abscess and scarring which commonly affects sweat glands. Are both underarms affected? Please send good quality photographs for confirmation of diagnosis and treatment.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I had a look at the photographs (attachment removed to protect patient identity). Clinically it is going in favor of hidradenitis suppurativa. It is an infection of apocrine sweat glands and is very resistant to treatment. So, long-term medication is necessary. Ultrasound was not needed in your case; instead deep punch biopsy would be confirmatory. Nevertheless, you can take the following medications:

Apply Clindac-A gel (Clindamycin phosphate 1%) twice daily.
Take a capsule of Dalcinex (Clindamycin) 300 mg twice daily.
One hour before meals have capsule R-Cinex (a combination of Isoniazid and Rifampicin) twice a day.
Every day take tablet Pantoprazole 40 mg half an hour before breakfast.

You may experience red urine after the medication do not be fearful as it is perfectly normal after raking R-Cinex as it is a red dye and is excreted in urine.

Thank you.