Hidradenitis suppurativa

Hidradenitis Suppurativa. Verneuil disease or hidradenitis suppurativa (HS) chronic, inflammatory, recurrent debilitating disease develops after puberty, with cutaneous and sub-cutaneous painfull nodules in the apocrine sweat glands regions (axillary inguinal and ano genital regions). Prevalence is 1% in Europe. Quality of life may be seriously impaired. HS is associated wtih over-weight, smoking, metabolic syndrome and some times with other inflammatory diseases (Crohn's colitis, spondylarthropathy). Main mechanism is occlusion of the hair follicule followed by lympho- histiocytic inflammation. A multi modal approach is advocated for treatment of inflammation with antibiotics and biologics. Surgery is useful in treatment of fibrotic lesions, singles or multiples fistulating nodules. Adjuvant care for metabolic syndrom, overweight, smoking is also recommended. Clinical scores and patients related outcomes are useful to evaluate treatments.