Hidradenitis Suppurativa
PATHOGENS
- Inflammatory disease around abnormal and dilated hair follicles with secondary involvement of apocrine glands and surrounding structures, often with superinfection.
- Genetic predisposition is possible; 40% have a family history of hidradenitis supperativa.
- Immune dysregulation in innate and adaptive immune pathways.
- Pathogenesis is believed to start with occlusion and dilation of the pilosebaceous unit → rupture → extrusion of follicular contents into dermis → chemotactic inflammatory response → influx of neutrophils, lymphocytes, histiocytes → abscess formation (thus, it is both an inflammatory disease related to immune dysregulation and infectious disease).
- Infection appears to result from inflammatory occlusion of ducts rather than the underlying process for hidradenitis suppurativa.
- Microbiology: culture may yield mixed aerobic/anaerobic bacteria with S. epidermidis and S. aureus most commonly isolated.
- Up to 50% of patients are culture-negative.
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Last updated: October 7, 2023
Citation
Hoffmann, Christopher J. "Hidradenitis Suppurativa." Johns Hopkins ABX Guide, The Johns Hopkins University, 2023. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540272/2.2/Hidradenitis_Suppurativa.
Hoffmann CJ. Hidradenitis Suppurativa. Johns Hopkins ABX Guide. The Johns Hopkins University; 2023. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540272/2.2/Hidradenitis_Suppurativa. Accessed November 9, 2024.
Hoffmann, C. J. (2023). Hidradenitis Suppurativa. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540272/2.2/Hidradenitis_Suppurativa
Hoffmann CJ. Hidradenitis Suppurativa [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2023. [cited 2024 November 09]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540272/2.2/Hidradenitis_Suppurativa.
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