Russell Natalie, Kpughur-Tule Ngumimi, Ravichandar Emmanuel, Dorta Torres Gerard, Tiesenga Frederick
Clinical Sciences, Saint James School of Medicine, Chicago, USA.
General Surgery, West Suburban Medical Center, Chicago, USA.
Cureus. 2023 Sep 22;15(9):e45788. doi: 10.7759/cureus.45788. eCollection 2023 Sep.
Hidradenitis suppurativa (HS), more commonly known as acne inversa, occurs due to chronic inflammation of the body's apocrine glands, most commonly affecting areas of the body where there is prolonged skin-on-skin friction. HS affects approximately 4% of the United States population, most commonly women in their second or third decade of life, especially those of African American ethnicity. HS presents as tender subcutaneous nodules which often rupture, leading to the formation of painful dermal abscesses which undergo fibrosis and lead to the formation of extensive sinus tracts, a phenomenon known as "tunneling". HS is staged clinically using the Hurley staging system, where the stage determines what treatment modalities are used. These modalities can include medical management such as antibiotics, or biologics such as tumor necrosis factor (TNF)-alpha inhibitors like adalimumab, as well as surgical options including incision with or without drainage. Due to the similar presentation of HS with other conditions, this disease is commonly misdiagnosed, often leading to delayed treatment initiation and worse outcomes for patients. Presented is a case report of a 30-year-old African American male with perianal HS and the potential long-term complications and challenges of management of this disease.
化脓性汗腺炎（HS），更常见的名称是反向痤疮，是由于人体顶泌汗腺的慢性炎症引起的，最常影响身体上皮肤与皮肤长期摩擦的部位。HS影响约4%的美国人口，最常见于二三十岁的女性，尤其是非裔美国人。HS表现为触痛性皮下结节，这些结节常破裂，导致形成疼痛的真皮脓肿，脓肿会发生纤维化并导致广泛的窦道形成，这一现象称为“窦道化”。HS在临床上采用赫利分期系统进行分期，分期决定了所采用的治疗方式。这些方式可包括药物治疗，如使用抗生素，或生物制剂，如肿瘤坏死因子（TNF）-α抑制剂，如阿达木单抗，以及手术选择，包括切开引流或不引流。由于HS与其他病症的表现相似，这种疾病常被误诊，往往导致治疗开始延迟，患者预后更差。本文介绍了一例30岁非裔美国男性肛周HS病例以及该疾病管理的潜在长期并发症和挑战。
