History of Hidradenitis Suppurativa
(pronounced: hide-ra-den-eye-tis sup-you-rah-tee-vah)
Hidradenitis Suppurativa (HS) is a chronic skin disease, which appears in the apocrine gland-bearing areas, such as the armpits, breasts, and groin. This recurrent inflammatory, and often painful disease is often overlooked, as not much is known of the actual cause.
HS was first depicted in 1833 by the French anatomist and surgeon Alfred-Armand-Louis-Marie Velpeau, which is where the name Velpeau's Disease originates. It was later investigated by French Surgeon, Aristide Auguste Stanislas Verneuil from 1854 to 1865, earning it the name Verneuil's Disease, and it was he who conducted the first clinical studies of HS.
Verneuil later renamed the disease Hidrosadenite Phlegmonous in 1864, which translates to the English Hidradenitis Suppurativa, meaning the inflammation of a sweat gland (Hidradenitis) containing or associated with pus (Suppurativa).
HS is diagnosed by looking at the 3 main characteristics of the disease:
Lesions - They are deep-seated nodules and/or fibrosis. Location - Armpit, groin, breast, and/or buttocks. Lesions can re-occur and are often chronic.
Here are some questions to be asked:
Does anyone else in your family suffer from similar symptoms? Do the nodules reoccur in the same area each time. Do they get worse during the premenstrual or menstrual cycle?
Unfortunately, the HS disease is not very well known and is quite often mistaken as common abscesses, boils, sexually transmitted diseases, skin infections, or just in-growing hair follicles, just to name a few. This in turn can lead to a delay inappropriate referrals, diagnosis, treatment, and therefore may result in further advancement of the disease.
HS is graded into 3 stages, known as Hurley's clinical staging. The early stages of HS present themselves as a single, inflamed, boil-like nodule. These will either slowly disappear or persist to become a suppurative (draining) absess(es), eventually degrading and scarring the affected area.
The later stages of the disease will see the affected areas spreading, with either single or multiple lesions with the formation of sinus tracts, or fistulas, where lesions drain from 1 or more locations. These sinus tracts can interlink and become more widespread in stage 3. There is no evidence that patients will progress to stage 3, as many do not progress further than stage 1. Some additional information on HS can be seen on the US National Library of Medicine National Institutes of Health Website, http://www.nlm.nih.gov/.