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Medical Edge Newspaper Column from Mayo Clinic

SURGERY MAY BE BEST WAY TO RELIEVE SERIOUS SKIN INFLAMMATION

DEAR MAYO CLINIC: I have a chronic condition, hidradenitis suppurativa, that I have been dealing with for two and a half years. In this time, I have had two unsuccessful surgeries to drain the infection, which caused me a great deal of pain and provided no results because the blisters returned in the same exact place (my groin area) just three short days later.

I’ve had corticosteroid injections from my dermatologist, which only provided me with temporary relief. I’ve been on every antibiotic that there is for extensive amounts of time, which also did not help but instead caused other issues. I have been to several doctors, gynecologists and dermatologists and no one seems to be able to help me.

I refuse to give up hope and accept the answer “some people are just prone to this type of thing, so deal with it.” There has to be some cure for this — I know I’m not the only sufferer in the world with this skin condition. If you have seen or successfully treated this annoying disease, I would greatly appreciate hearing about it. — Chicago

ANSWER: Yes, we see patients with this condition, and the frustration you voice is common. Based on the partial description you provide, I would recommend you discuss with your physician the possibility of having surgery to remove the most involved areas.

“Hidradenitis” is the medical term for inflammation of hair follicles, oil ducts and sweat glands in the skin. The term “suppurativa” means that the infection causes pus to form. Hidradenitis suppurativa typically begins at or after puberty, and many cases are hereditary. HS consists of multiple blackheads, pustules and abscesses on the skin, which lead to pain and scarring. Folded skin areas — underarms, groin, buttocks and under the breasts — are often involved. Obesity and smoking aggravate this disease.

Standard treatment options include: topical retinoids and antibiotics; systemic antibiotics chosen based on cultures taken from the wounds; injections of corticosteroids; incision and drainage procedures; and systemic retinoids. Most recently, doctors have begun using antitumor necrosis factor medications to treat HS.

Many physicians feel that radical excision surgery should be done to remove very active areas — and the earlier it’s done, the better. Patients also should see a dietitian for help losing weight. And if you smoke cigarettes, stop.

— Gabriel Sciallis, M.D., Dermatology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Department of Dermatology
Appointment Information
Hidradenitis Suppurativa

READERS: Heart disease is the number one killer of women, causing twice as many deaths as all forms of cancer combined. And each year, more U.S. women than men die of the disease.

Heart disease is progressive — not a condition that just suddenly appears. It’s the cumulative effect of lifestyle choices made during the 20s and beyond. To reduce the risk of heart disease, young women should make the following heart-healthy lifestyle and behavior choices:

— Stop smoking. Smoking is the greatest risk to cardiovascular health. Research shows that no level of smoking is safe. Even one, two or three cigarettes a day double your chances of heart disease.

— Increase physical activity. Keep moving and exerting yourself — you don’t need to run a marathon. Just by staying active, you can reduce your chances of heart disease by 30 to 50 percent.

— Maintain a healthy weight and eat lots of fruits and vegetables rich in antioxidants and fiber. This will help improve how well your heart pumps blood, lower your blood cholesterol level and decrease blood pressure.

Additional Resources:
Treatment of Cardiovascular Disease
Appointment Information
Women and Heart Disease

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.