Care of Clients with

Hidradenitis Suppurativa
(Acne Inversa)

Prepared by:
Opolinto, John Michael R.
BSN 301

Hidradenitis Suppurativa

a chronic skin disease characterized

by clusters of abscesses, epidermoid
and sebaceous cysts, that most
commonly affects apocrine sweat
gland bearing areas, such as
the underarms, under the breasts,
inner thighs, groin and buttocks.

Causes

Post-pubescent individuals are more likely to

exhibit HS
Plugged apocrine (sweat) gland or hair follicle
Excessive sweating
Sometimes linked with other autoimmune conditions
Androgen dysfunction
Genetic disorders that alter cell structure
Patients with more advanced cases may find
exercise intolerably painful, which may
increase the rate of obesity among sufferers.

Triggering factors

Obesity is an exacerbating rather than a

triggering factor, through
mechanical irritation, occlusion,
and maceration.
Tight clothing, and clothing made of heavy,
non-breathable materials.
Deodorants, depilation products, shaving of
the affected area their association with
hidradenitis suppurativa is still an
ongoing debate amongst researchers.
Drugs, in particular oral contraceptives (i.e.,
oral hormonal birth control; "the pill")
and lithium.
Hot and especially humid climates (dry/arid
climates often cause remission).

Risk Factors
- Obesity - Bacteria
- Tight clothing -Stress
- Chemicals
- Humid climates
Eccrine glands
(all over body)
Apocrine glands
(axillary,
anogenital skin)

Pimple and
boil breakout
upon
assessment
inflammation

Hair follicle
Follicular
hyperkeratosis

comedo

Follicular rupture

C&S T of
fluid (+) for
S. Areus

Recruitment of neutrophils

Granulomatous infiltrate with

foreign body cells

Dermal abscess
extends to
subcutaneous fat
Chronic inflammation

fibrosis
Formation of sinus
tracts

Redness
Warmth
Pain
Pus formation

Treatment (Lifestyle)

Changes in diet avoiding inflammatory foods,

foods high in refined carbohydrates.
Warm compresses with distilled vinegar
water, and taking hot baths with distilled white
vinegar in the water hydrotherapy,
Icing the inflamed area daily until pain
reduction is noticed.
Weight loss in overweight and obese
patients, as well as smoking cessation can
improve or even alleviate many symptoms of
HS
Washing with benzoyl peroxide can be
effective.

Medications

Antibiotics- taken orally, these are used for their antiinflammatory properties rather than to treat infection.
Most effective is a combination of rifampicin and
clindamycin given concurrently for 23 months. This
brings about remission in around three quarters of
cases. A few popular antibiotics used to treat HS
include tetracycline, minocycline, and clindamycin.
Corticosteroid injections. Also known as intralesional
steroids: can be particularly useful for localized
disease, if the drug can be prevented from escaping
via the sinuses.
Vitamin A supplementation
Anti-androgen therapy: hormonal therapy
with cyproterone acetate and ethinyl estradiol proved
effective in randomized, controlled trials. Dosages
reported have been very high.

Other treatment
Radiation
Surgery
Laser Hair Removal

Nursing Diagnosis
Acute Pain
Disturbed Body Image
Isolation