Acne inversa

Acne inversa  also known as Hidradenitis suppurativa is a disabilitating chronic inflammatory disease with major negative impact on quality of life and significant co-morbidities. It usually begins as pimple-like bumps on the skin. The pimple-like bumps develop in places that everyday pimples do not appear. It is most common on the underarms and groin. Acne inversa does not form on the face or back.

If you have this skin disease, you may notice breakouts on your skin that look like pimples or boils. Your skin may clear for a while, but you notice new breakouts develop in the same area.

Symptoms start after puberty  sometimes with a single bump and can develop into multiple blackheads, pustules and deep-seated boils that can persist for years. Other symptoms of acne-inversa include itching, burning and excessive sweating.

Causes

Acne-inversa develops when sebaceous glands and hair follicles become blocked with dead skin cells and sebum. Infection and inflammation caused by bacteria also play a role. dermatologists don't  exactly know what causes the follicles to become blocked.

The three stages of acne inversa

Stage 1

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Stage 1 of acne-inversa features lesions and sinus tracts, or tunnels, into the skin; there will be separation between the tunnels. Three-quarters of all acne-inversa cases never progress beyond this stage.

Stage 2

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In Stage 2, the sinus tracts connect to each other, forming a network under the skin. Excess, thickened scar tissue is also present.

Stage 3

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In Stage 3, large areas of suppurating, fibrous tissue develop.

Features

The disease starts with inflammatory, painful nodules and sterile abscesses followed by tissue fibrosis. It affects at least one percent of the population. Age, gender and family history are considered the main risk factors responsible for the disease.

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Unlike everyday pimples, acne-inversa (hidradenitis suppurativa) forms in areas where skin touches skin.

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It is most common in these areas:

• Underarms
• Groin (genitals, around the anus, and surrounding area)
• Buttocks
• Upper thighs
• Women’s breasts (underneath and sometimes on the breasts)
• Rarely  near an ear, around the bellybutton, or on the back of the neck.
• Women tend to get breakouts on their genitals and upper thighs. Men are more likely to have acne inversa on their genitals and around the anus.
  

Treatments

Acne-inversa treatment depends on the severity of the disease. Each stages have different methods of treatments. In general, there are three levels in the management of this disease: Topical options, systemic options, and surgical methods, including laser therapy.

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There is no cure for acne-inversa. But early treatment can help manage the symptoms and may prevent new lesions from developing.

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Although laser and light seem to be attractive in controlling the disease, the cure rate is low and the time needed to improvement is longer. Surgery is a cornerstone for acute abscess pain relief and for treatment of advanced stage 2 and 3 acne-inversa. Stage 3 often requires wide excision surgery, radiation therapy and skin grafts.

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Tags

blackheads, pustules, Topical, laser therapy