Hidradenitis Suppurativa: A Challenging Skin Condition That Often Gets Misdiagnosed

Back in September, Luminary Dermatology introduced our readers to Hidradenitis suppurativa, or HS. Let’s delve deeper into the challenging skin condition and why it often goes misdiagnosed.

Hidradenitis suppurativa is an inflammatory skin disease that progressively causes a rash under the skin that is made up of lumps which are fluid-filled sacs—similar to boils. The bumps are a result of blocked hair follicles that harbor bacteria leading to inflammation and a stinging rash. The bumps are painful and often break open, which cause drainage, pus, and abscesses. Hidradenitis suppurativa is debilitating for patients due to the pain and irritation. Hidradenitis suppurativa also causes scarring, and in some severe cases, disfigurement.

What causes hidradenitis suppurativa?

Hidradenitis suppurativa can affect any area of the body, but typically is found in areas the rub together causing friction, such as the armpits, groin, and inner thighs. Although there is no known cause, specialists purport that it is associated with genetic changes, hormonal imbalances, and a family history.

Was my hidradenitis suppurativa misdiagnosed?

Symptoms of hidradenitis suppurativa usually begin earlier in life (teens and twenties), and it affects females more than males. As with any illness, early diagnosis is best and provides the best outcomes for the patient. However, hidradenitis suppurativa is a challenging skin disorder that often goes undiagnosed or misdiagnosed. This common misdiagnosis frequently puts patients at greater risk of disease progression and becoming more difficult to treat.

What are the treatment options for hidradenitis suppurativa?

Cases of hidradenitis suppurativa range from mild to severe. Mild cases can usually be controlled with medications and topical treatment. Medications can be administered orally or by injection; these include steroids, pain relievers, and antibiotics. For those with moderate to severe hidradenitis suppurativa, surgery may be optimal. Surgery can include excisions and skin grafting and requires a specialist familiar with the disease state and able to make grafts with minimal to no scarring.

Lifestyle Changes Can Help

In addition to medications and surgery, patients may find it beneficial to wear loose clothing that is breathable such as cotton or linen. They should also avoid humidity. If individuals smoke, stopping smoking can help relieve the irritation and outbreaks. Getting hormone levels checked and treated is also helpful.

Luminary Dermatologist, Harib Ezaldein, MD actually specializes in hidradenitis suppurativa. Dr. Harib Ezaldein specializes in an intricate procedure to treat severe cases of hidradenitis suppurativa, which requires surgery to remove the scars, lumps, and abnormalities. Dr. Ezaldein is a board-certified dermatologist and fellowship-trained Mohs surgeon who specializes in skin cancer surgery, reconstruction, hidradenitis suppurativa, and complex medical dermatology.

“This is a very rewarding condition to treat due to its chronic and unrelenting clinical course,” says Dr. Ezaldein. “Unfortunately, awareness of this condition is relatively low and many patients try several unsuccessful medical and immunosuppressive regimens before considering surgery. An earlier chance to cut is a greater chance to cure, in my opinion” Dr. Ezaldein adds.

Dr. Ezaldein studied engineering and economics as an undergraduate at Yale University, where he also completed medical school. As a medical student, his research was funded by the Howard Hughes Medical Institute to develop cellular immunotherapy and a melanoma cancer vaccine.

After graduating, he moved to Seattle to pursue training at the University of Washington, with a heavy concentration on plastics and burn surgery. He completed his dermatology residency in Cleveland, Ohio at Case Western Reserve University, where he served as chief resident of academic research.

After residency, he moved to Los Angeles to train with Dr. Richard Bennett, the internationally recognized and renowned Mohs surgeon. This rigorous apprenticeship provided abundant experience with high-risk tumors such as melanoma, complex facial reconstruction, hidradenitis suppurativa surgeries, and traditional principles of surgical practice.

With over 80 scientific publications, Dr. Ezaldein has an interest in dermatology research and mentoring medical students. He is particularly interested in collaborations and conducting clinical trials for innovative and meaningful therapies.

To schedule your appointment with Dr. Ezaldein click here!