Brown T J, Rosen T, Orengo I F
Department of Dermatology, Baylor College of Medicine, and the Veterans Administration Medical Center, Houston, Tex 77030, USA.
South Med J. 1998 Dec;91(12):1107-14. doi: 10.1097/00007611-199812000-00003.
Hidradenitis suppurativa (HS) is a recurrent, suppurative disease manifested by abscesses, fistulas, and scarring.
We reviewed the literature to identify reliable information regarding epidemiology, pathogenesis, clinical manifestations, evaluation and differential diagnosis, treatment, complications, and prognosis.
Hidradenitis suppurativa usually affects young women, with a prevalence of 0.3% to 4% in industrialized countries. Once considered to be "apocrine acne," HS is actually a defect of terminal follicular epithelium. Obesity, chemical irritants, or hyperandrogenism are not consistently associated; bacterial involvement is secondary. Hidradenitis suppurativa should be suspected in young adults with recurrent, deep furuncular lesions in flexural sites, especially when such lesions respond poorly to antibiotic therapy. Clindamycin and isotretinoin may be useful, though wide excision with healing by granulation is considered most efficacious. Anemia, arthropathy, and squamous cell carcinoma are potential complications.
Since spontaneous resolution is rare and progressive disability the rule, early definitive surgical treatment of HS is advisable.
化脓性汗腺炎（HS）是一种复发性化脓性疾病，表现为脓肿、瘘管和瘢痕形成。
我们查阅文献以确定有关流行病学、发病机制、临床表现、评估与鉴别诊断、治疗、并发症及预后的可靠信息。
化脓性汗腺炎通常影响年轻女性，在工业化国家患病率为0.3%至4%。HS曾被认为是“大汗腺痤疮”，实际上是终末毛囊上皮的一种缺陷。肥胖、化学刺激物或高雄激素血症与之并无始终一致的关联；细菌感染是继发性的。对于在屈侧部位有复发性、深部疖样损害的年轻人，尤其是对抗生素治疗反应不佳时，应怀疑化脓性汗腺炎。克林霉素和异维A酸可能有效，不过通过肉芽组织愈合的广泛切除被认为最为有效。贫血、关节病和鳞状细胞癌是潜在并发症。
由于自发缓解罕见且病情通常会逐渐加重，化脓性汗腺炎早期进行明确的手术治疗是可取的。
