Hidradenitis: causes of inflammation and characteristic symptoms, how to treat a bitch udder at home. Hidradenitis: how to treat "bitch udder" at home Bitch udder in the armpit than to treat

Hidradenitis is a purulent inflammation of the sweat glands. It belongs to staphylococcal and streptococcal pyoderma and represents one of the most extensive groups of inflammatory dermatological diseases.

Children and the elderly do not fall into the risk group for hydradenitis, since in the first sweat glands begin to function at the age of puberty, and in older people their action is already fading.

Hydradenitis under the arm is a common deep staphylococcal pyoderma. The disease is characterized by a long course, frequent relapses and a high risk of complications. The axillary region is not the only one for the development of hidradenitis.

Treatment of hidradenitis should be done by a dermatologist or surgeon (if necessary, opening and draining the abscess). Self-treatment of the disease is categorically contraindicated, since purulent hydradenitis can quickly be complicated by the development of multiple abscesses, fistulas, phlegmon, lymphadenitis, lymphangitis, sepsis, etc.

Attention. Frequent recurrences of suppurative hidradenitis, accompanied by blockage and rupture of the hair follicle, significantly increase the patient's risk of squamous cell carcinoma.

Code hydradenitis ICD10 - L73.2.

For reference. Hidradenitis is an infectious lesion of the sweat glands (apocrine type of glands). Also, with this disease can be affected and sebaceous glands. People call the disease bitch udder.

Hydradenitis in women is much more common than in men.

The leading cause of the development of the disease is Staphylococcus aureus. As a rule, pathogens enter the apocrine sweat or sebaceous glands from the hair follicles. In the future, there is a lymphogenous spread of the infectious process.

Hidradenitis under the arm is most common, but the disease can also affect the sweat and sebaceous glands on the areola of the nipples, on the vulva, the skin of the navel and around the anus.

Clinical symptoms with hidradenitis progress slowly, but in debilitated patients or in patients with pathologies immune system, the disease can proceed in an acute form with the rapid development of severe complications. Also, severe forms of hydradenitis with a fulminant course are often found in patients of the Negroid race.

For reference. Most often, hidradenitis is recorded in patients from twenty to forty years old.

Hydradenitis under the armpits are found mainly in women. In men, the glands of the perineum are usually affected. Hydradenitis in the groin in women is extremely rare.

In elderly patients, hidradenitis is not recorded, due to a decrease in the activity of sweat and sebaceous glands. Also, the disease is practically not recorded in children, before puberty.

Hydradenitis - causes

The leading cause of hydradenitis is Staphylococcus aureus. Less commonly, hydradenitis is caused by group A beta-hemolytic streptococci, non-hemolytic streptococci, Escherichia coli, Proteus, Pseudomonas aeruginosa. Also, hydradenitis can be caused by a mixed microbial flora.

An important role in the development of the disease is played by an increase in the level of androgens (in this regard, in young children and women after menopause, the disease does not occur).

Important. The development of hydradenitis is often hereditary.

In the family history of such patients, the presence of hidradenitis, purulent arthritis, pyoderma gangrenosum, abscessing folliculitis of the scalp (undermining Hoffmann folliculitis), and abscessing forms of acne are often noted in close relatives.

Risk factors for the development of hidradenitis are the presence of:

• constant skin irritation after shaving;
• abrasions, scratches, cracks, thinning of the skin;
• excessive sweating (hyperhidrosis);
• improper use of depilatory products;
• improper hygienic skin care;
• obesity;
• diabetes;
• hyperandrogenism;
• diaper rash
• immunodeficiency states;
• foci of chronic infection;
• concomitant staphyloderma or streptoderma;
• obstruction of the ducts of the sebaceous or sweat glands;
• pathologies of the sebaceous or sweat glands;
• obstruction of hair follicles;
• associated acute bacterial infections.

Attention! In women with a tendency to form hidradenitis, severe exacerbations of the disease are possible during childbearing.

Contribute to the development of hidradenitis in the perineum may be the patient's sexually transmitted infections.

Classification of hydradenitis

Depending on the localization of the inflammatory process, hydradenitis is isolated in the armpits, perineum, near the nipples, etc.

According to the rate of progression of clinical symptoms and the duration of the course of the inflammatory process, acute, subacute and chronic form diseases.

The severity of the disease can be mild, moderate and severe.

There are also uncomplicated and complicated forms of hydradenitis.

Hydradenitis - stages

For reference. Suppurative hydradenitis is further classified according to the Harley system (degrees of suppurative hydradenitis).

The disease of the first degree is manifested by the occurrence of single or multiple isolated abscesses that are not accompanied by cicatricial changes in the skin and the formation of fistulous tracts.

Hydradenitis of the second degree is accompanied by the formation of recurrent abscesses, as well as single or multiple cicatricial changes in the skin and fistulous tracts.

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With hydradenitis of the third degree, the development of a diffuse inflammatory process or the formation of several associated fistulous tracts and abscesses is noted.

Symptoms of hidradenitis

Most often, the clinical symptoms of the disease progress slowly. The rapid progression of the disease is characteristic of severe forms disease and carry a high risk of complications.

In patients with normal immunity, hidradenitis that first appeared may occur in mild form. However, the more often the disease recurs, the more severe it is. inflammatory process. As a rule, often recurrent hidradenitis responds worse to drug treatment.

For reference. The inflammatory process in the armpits, as a rule, is unilateral, but bilateral inflammations can also occur.

Harbingers of the development of hydradenitis can be:

• slight swelling, swelling of the skin;
• slight redness of the skin;
• itching and tightness of the skin;
• feeling of discomfort.

The first manifestation of hidradenitis is the occurrence of single or multiple nodules under the skin. On palpation, the nodules are dense (softening of the formation indicates its purulent fusion), painful, mobile (not soldered to surrounding tissues).

With recurrent hidradenitis, the inflammatory formation can be immobile and soldered to the surrounding tissues.

For reference. The size of the formation gradually increases to several centimeters. Large nodes can reach three to four centimeters in diameter.

The color of the inflammatory formation with hidradenitis can vary from bright red to maroon or cyanotic purple.

The surface of the formation is uneven and bumpy due to the formation of conglomerates from nodules in it. In some cases, inflammatory papillae may protrude above the surface of healthy skin (hence vernacular name disease "bitch's udder").

Inflammatory nodes are sharply painful, the skin over them is stretched and tense. Around the node there is a rim of inflammatory hyperemia (redness) and swelling.

Increased pain during movement is characteristic. Large nodes can hurt even at rest.

Multiple nodes can merge with each other or connect with fistulous passages.

In some cases, infiltrative formations can merge with the skin, resembling a picture of diffuse phlegmon.

The general condition of the patient is disturbed. In addition to severe pain, patients are worried about:

• increase in body temperature up to 39-40 degrees;
• muscle and joint pain.
• weakness, lethargy;
• nausea, loss of appetite;
• fever.

Also characterized by an increase lymph nodes in the area of ​​\u200b\u200bthe inflammatory process (axillary lymph nodes, supra and subclavian with hydradenitis in the armpit, inguinal and popliteal lymph nodes with hydradenitis in the groin, on the labia, etc.).

Attention. Due to the stagnation of lymph (lymphostasis), swelling of the limb may occur.

With hidradenitis in the perineum, pain may increase when walking or sitting. Hidradenitis near the anus is accompanied by a sharp increase in pain during bowel movements. The pain is also aggravated by wearing tight clothing.

With hydradenitis near the anus, it is necessary to exclude paraproctitis.

With hydradenitis on the labia majora, lameness is possible on one leg when walking (due to severe pain), the inability to sit normally, pain during urination.

The disease should be differentiated from bartholinitis (inflammation of the large glands of the vaginal vestibule).

Hydradenitis in the axillary region is accompanied by increased pain when moving the arm.

With the progression of the disease, the inflammatory node suppurates. Softening appears in the center of the node, it is noted positive symptom fluctuations (oscillations of pus or fluid in a closed cavity).

At this stage, the clinical picture of the disease is similar to the symptoms of a boil or carbuncle.

Attention. The main difference between hydradenitis and boil there will be no purulent-necrotic core. Purulent contents with hydradenitis are viscous-liquid, mixed with blood.

During the autopsy of inflammatory infiltrates, multiple fistulous passages are often found connecting nodes or abscesses.

During the subsidence of the inflammatory process, the formation of retracted, hypotrophic scars occurs. Often, after the healing of one fistula, a new fistula opens near the already healed scar.

In some cases, nodes can open on their own. However, in order to reduce the risk of developing dangerous complications and the transition of acute forms of the disease to chronic (recurrent), the opening of the nodes should be carried out in a surgical department. Since during the surgical opening of the abscess, it is possible to drain and rinse with antimicrobial and antiseptic solutions at once all fistulous passages and abscess cavities.

Treatment at home can only be carried out under the supervision of a doctor, at the stage of formation of a purulent infiltrate.

At the stage of maturation of infiltrative formations, progression of fever, weakness, pain syndrome, etc. is noted. After opening the abscesses and draining the pus, there is a rapid improvement in the patient's well-being.

For reference. On average, the gradual suppuration of the nodes begins on the fourth or fifth day of illness. The total duration of uncomplicated, acute hydradenitis is from ten to fifteen days. Scarring of the opened node takes two to three days.

In patients with diabetes mellitus, immunodeficiencies, etc. the disease can last much longer.

The cause of pain in the armpit is often hydradenitis - inflammation of the sweat glands. It is provoked by various factors. The development of the disease often leads to a violation of the rules of hygiene and the use of low-quality cosmetics.

Hydradenitis - what is it?

Hidradenitis is an inflammation of the apocrine sweat glands, which are located in various parts of the body. A large concentration of them is observed in the axillary region, around the nipples, in the groin, on the labia majora and scrotum. However, the axillary glands are predominantly affected, inguinal hidradenitis is rare. The development of pathology is partly due to the peculiarities of their structure.

The cells of the apocrine glands are located at the top of the excretory duct, they are constantly destroyed and mixed with sweat released to the outside. The secret contains a large amount of fat, which increases the density of sweat and gives it a peculiar smell. The glands in the armpit are larger, winding passages, which increases the risk of inflammation several times.

Hydradenitis - causes

Due to the characteristic appearance, which acquires the armpit with hydradenitis, the disease is popularly called "bitch's udder". Having heard about such a disease for the first time, many are interested in what causes the bitch udder and how it manifests itself. In most cases, the causative agent is pathogenic microflora:

• staphylococcus;

A bitch udder under the arm provokes a number of the following factors:

• increased sweating;
• excess body weight;
• diseases of the skin - diaper rash;
• pathology endocrine system (diabetes);
• violation of hygiene rules;
• constant use of antiperspirants;
• poor working conditions - work in dusty conditions, contact with harmful substances;
• decrease in the body's defenses;
• rough;
• the presence in the body of a chronic focus of infection;
• frequent stressful situations;
• individual structural features of the apocrine glands.

Why is hydradenitis dangerous?

A long-term presence of a bough udder, lack of therapy, proper skin care is fraught with the development of complications. On the surface of contaminated, weeping skin, the infection develops rapidly with the capture of new areas. This can lead to the development of an abscess. This is observed when inflammation of the sweat glands in the armpit affects several adjacent structures. The abscesses merge, destroying the subcutaneous tissue, in some cases the pathology even reaches the muscle fibers.

Lack of treatment at this stage leads to the formation of phlegmon - diffuse, purulent inflammation of the sweat glands. It has no clear boundaries and spreads through the subcutaneous tissue. Such conditions in rare cases can lead to sepsis - blood poisoning, which often ends in death.

Hidradenitis - symptoms

Regular hygiene procedures allow you to detect hydradenitis under the arm at the initial stage of the disease. At first, the patient can feel small nodules under the skin, pressure on which provokes pain. In parallel, itching and hyperemia of the skin at the site of inflammation are noted. After a few days, the nodules rapidly increase in size, becoming like large peas - 1-2 cm in diameter.

Among common symptoms accompanying hydradenitis:

• increase in body temperature;
• general malaise;
• headache;
• weakness;
• nausea.

As the disease progresses, the central part of the infiltrate softens. As a result, during examination, purulent contents become noticeable through a thin skin, which in some cases spontaneously pours out. After that, the patient notices an improvement in general well-being, a decrease in pain in the axillary region.

Stages of hydradenitis

As the inflammatory process develops, purulent hydradenitis in its course overcomes the following stages:

1. 1 stage- characterized by the gradual formation of an abscess (sometimes several), which does not have fistulous passages and scars.
2. 2 stage- accompanied by the appearance of one or more distant, periodically recurring abscesses with the formation of scars or fistulous passages.
3. 3 stage- characterized by the formation of diffuse branching or, on the contrary, by the connection of several fistulous passages and abscesses, which increases the affected area.

Hidradenitis - treatment

How to treat a bough udder, what to do to get rid of pain in the axillary region are common questions from patients with hydradenitis.

Only after a diagnosis has been made can treatment begin. Treatment is complex and depends on a number of factors:

• patient's age;
• gender;
• the presence of concomitant diseases;
• general condition immune system.

With a single inflammation of the gland, the distant location of the foci of inflammation from each other, doctors manage to quickly eliminate the disease. However, much depends on the patients themselves, the correctness and regularity of the hygiene procedures. It is necessary to carefully care for the skin around the focus of inflammation, wiping it with an antiseptic (salicylic, camphor alcohol). It is forbidden to take baths during treatment - bathing will contribute to the spread of infection. Doctors advise limiting yourself to a shower.

Ointment for hydradenitis

When a bough udder is found in a patient, treatment is not carried out without the use of local remedies. These are antiseptic solutions, creams and ointments. Due to local effects, they quickly eliminate inflammation. To enhance the therapeutic effect, the armpit area is previously freed from hair.

The skin is regularly worked out with the following antiseptics:

• ethanol;
• brilliant green;

After that, an anti-inflammatory cream or ointment is applied to the site of inflammation. The cream with resorcinol 15% proved to be excellent. It is applied to the affected area, after which a bandage is applied to the armpit. The procedure is performed 1 time per day, the duration of the course of treatment is determined by the doctor.

Hidradenitis - antibiotic treatment

Antibiotics for hydradenitis are selected based on the type of pathogen. This reduces the duration of therapy and speeds up the healing process. Dosage, frequency of administration are set individually, taking into account the severity of the inflammatory process and the general well-being of the patient.

Treatment with antibiotics is carried out until the visible manifestations of the inflammatory process are eliminated. In most cases, therapy includes parallel treatment of the focus with antiseptic solutions. Prolonged lack of effect, deterioration of well-being requires a revision of the antibacterial agent or an increase in the dosage of the drug.

Hydradenitis - folk remedies

In cases where it is not possible to eliminate the bough udder for a long time, treatment with folk remedies helps to correct the situation. There are many simple recipes helping to eliminate inflammation in the armpit. Among the effective ones are the following.

Hydradenitis - operation

When, after prolonged conservative therapy, it is not possible to eliminate hidradenitis, removal of the abscess is the only method of treatment. Surgical intervention is prescribed when the center of inflammation has softened or an independent opening of the abscess has occurred:

1. The surgeon makes a wide incision to gain access to the entire lesion.
2. After that, all the pus is removed along with fatty tissue in the focus of inflammation.
3. Next, install the drain.
4. Wound healing occurs by secondary intention.

Hydradenitis - prevention

To never know what a bitch's udder is, the disease that accompanies severe pain, doctors recommend sticking to simple rules.

Hidradenitis (mcb 10 L73.2 purulent hydradenitis) is an inflammation of the sweat glands, which most often occurs in the groin or under the arm. Also, this disease can affect areas of the skin that are localized:

• around the anus;
• near the nipples;
• on the labia in women;
• near the navel;
• on the scalp;
• on the scrotum in men.

In the people, hydradenitis is called a bough udder. This disease occurs with equal probability in both men and women. Hidradenitis does not affect the elderly, because the activity of the sweat glands is inhibited with age. Most often, the disease manifests itself in the summer, when the air temperature is high enough, and the person sweats a lot.

Stages of hydradenitis:

• stage of infiltration;
• stage of suppuration;
• an abscess has formed and may rupture.

Inflammation of the sweat glands with hydradenitis is most often provoked by the activity of streptococci, staphylococci and other bacteria. They enter the body through excretory ducts on the skin.

Classification of hydradenitis:

• purulent hydradenitis;
• axillary hydradenitis;
• inguinal hydradenitis;
• chronic hydradenitis;
• suppurative hydradenitis.

Causes of hydradenitis

The main reasons for the development of hidradenitis, regardless of the location of inflammation:

• decrease in body resistance;
• hyperactivity of sweat glands;
• frequent injury to the skin;
• disregard for personal hygiene;
• as a consequence of dermatoses, which are accompanied by severe itching;
• immunosuppressive states;
• diabetes.

The causes of hydradenitis under the arm are non-compliance with personal hygiene, the formation of microtraumas and cuts from a razor. The provoking factor may be the use of low-quality depilatory products. Deodorant can also cause hydradenitis if used very often.

Purulent hydradenitis - causes

The causes of hidradenitis, which is accompanied by the accumulation of pus inside the sweat gland, are considered to be non-compliance with the rules of hygiene and untimely treatment of this disease. If, when a small swelling appears, you do not pay attention to it, over time, the skin in this place begins to become more inflamed. The resulting pimple grows rapidly in size and can reach 15-20 mm in diameter.

Gradually, the swelling softens, and pus begins to flow from its center. When the hydradenitis is opened, there are strong pain sensations, as an open wound is formed. This process can take 7-10 days. At proper treatment hidradenitis after opening the formation, a scar forms in its place.

Hydradenitis - the initial stage

At the initial stage of hydradenitis, some discomfort and tingling are felt under the armpit or in the groin. If you examine the skin, you can clearly see a small red pimple. In the initial stage of the disease, only one sweat gland is affected, and as hydradenitis develops, adjacent ducts may become inflamed.

This problem is characterized by the accumulation of secretion in the skin pore or near the hair follicle. Under these conditions, which are quite favorable for various bacteria, an inflammatory process develops.

Recurrent hydradenitis

Chronic or recurrent hydradenitis is characterized by the appearance of extensive inflammation of the sweat glands, which lasts for a long time. This form of the disease is considered the most difficult. It requires careful diagnosis and treatment. It is important to identify the causes that provoked such a long inflammatory process in the body.

Abscess - frequent complication recurrent hidradenitis, which may appear without timely complex treatment.

Suppurative hydradenitis

Suppurative hydradenitis of the armpit or other area of ​​the skin appears due to blockage and rupture of the hair follicle. The disease is characterized by the formation of an inflammatory process that affects the sweat glands.

Another name for this form of hydradenitis is acne inversion. This disease affects a person after puberty. Its feature is the combination of inflammation of the sweat glands with various forms acne. Hidradenitis can sometimes appear on the face or neck.

Causes given state skin is considered wearing uncomfortable clothing that rubs the skin. Also a provoking factor is obesity and increased sweating.

Hydradenitis in the groin

Hydradenitis in the groin area arises from tight and uncomfortable underwear that can rub. Microtraumas and diaper rash that form on the skin become the entrance gate for infection. Hydradenitis in an intimate place may appear from the frequent use of razors. Also, non-compliance with the rules of personal hygiene is directly related to this disease.

Hidradenitis in the groin in women appears in places where the apocrine glands are localized. It is characterized by the formation of dense nodes that cause pain.

Hydradenitis on the labia is accompanied by the formation of small formations protruding above the skin. Over time, they begin to increase in size and reach a diameter of 1-2 cm. At the same time, the problem area of ​​​​the skin acquires a bluish tint. Hydradenitis on the labia is diagnosed by a gynecologist after conducting appropriate tests. This disease is characterized by simultaneous damage to several sweat glands.

When diagnosing hidradenitis in the groin, treatment should be started immediately. If nothing is done after a while, the subcutaneous fatty tissue is affected.

Hydradenitis in men can be manifested by the appearance of painful seals on the scrotum.

Hydradenitis under the arm

Axillary hydradenitis in the stage of infiltration is accompanied by inflammation of the sweat glands, mainly on one side. In this case, small dense nodules are formed, which, when palpated, cause a painful sensation. Over time, the discomfort increases as the formations increase in size and begin to fester.

In some cases, hydradenitis of the mammary gland can be observed. In this case, nodules appear near the nipples. Especially dangerous is hydradenitis during pregnancy or hydradenitis during breastfeeding. This state without effective treatment can harm not only the mother, but also the child. The inflammatory process in a woman's body can cause other more dangerous conditions.

Which doctor should I contact with hydradenitis?

Hydradenitis enough dangerous disease because in severe cases it can cause sepsis. Therefore, when identifying the first symptoms, you need to contact a dermatologist who will conduct an examination and prescribe adequate treatment. In most cases, antibiotics are used, which are detrimental to pathogenic bacteria.

If hidradenitis has passed to the stage of suppuration, its treatment can only be performed surgically. In this case, you need to contact a regular surgeon.

When hydradenitis appears in children, it is imperative to contact a pediatrician who will examine the baby and prescribe a specific treatment. It is also important to exclude other diseases that are characterized by similar symptoms.

Also note that hydradenitis is not contagious. The only exception is hair removal products, which can only be used by one person.

Symptoms

The clinical picture of hidradenitis, as a rule, unfolds with a certain dynamics and is characterized by similar symptoms in various people. It is very important to note that if any of the symptoms described below appear, a person should immediately contact medical institution to receive professional medical care.

The clinical picture of hydradenitis

Hidradenitis predominantly affects the sweat glands of one armpit and is considered unilateral. This is one of the features of the manifestation of the clinical picture.

In the initial stage of the development of the disease (stage of infiltration), the appearance of dense nodules of small diameter is observed in the skin, which can be easily felt under the skin. At the same time, their appearance is accompanied by a feeling of itching and slight pain, which increases with pressure on the nodules. The skin over the altered sweat glands becomes hyperemic. There is pain in the armpit when moving the hand.

The nodules grow rapidly and reach a diameter of up to 1.5 - 2 cm, solder with the skin and with each other. They can be seen on the skin in the form of pear-shaped tubercles with a considerable height. At the same time, outwardly they resemble the nipples of a dog, which is reflected in the trivial name of the disease - “bitch's udder”. The skin above them becomes purple-red, edematous and acquires a shine, which is associated with its tension. Soreness increases and now manifests itself not only with movements of the limb or pressure on the nodules, but also at rest. With further progression of hidradenitis, the nodules merge with each other and form large painful conglomerates, outwardly creating the illusion of general inflammation. subcutaneous tissue, which can introduce difficulties in the process of differential diagnosis of the disease. This stage of the development of the disease is called the stage of maturation of hydradenitis, and, in addition to local symptoms, it is manifested by an increase in body temperature, general weakness, stiffness and soreness of the muscles, headache and other symptoms of malaise.

If left untreated, the disease progresses. Purulent inflammation begins in the subcutaneous nodules, which is accompanied by their melting and the release of pus from under the skin. At the same time, the pus is thick (similar in consistency to sour cream) and very often contains bloody impurities. At this stage of the development of the disease, the skin at the site of the lesion becomes soft to the touch, of a doughy consistency, which is associated with the presence of purulent foci under it. At this stage of the development of hidradenitis, it must be differentiated from the furuncle of the axillary region, this can be helped by the fact that there is no purulent core, which is observed in 100% of cases with the latter disease. After opening the festering node, the patient's condition improves: the temperature decreases and the symptoms of intoxication disappear. Visually, ulcers are formed at the site of the former nodes, characterized by a long healing process. After them, a retracted scar remains on the skin.

With the progression of the disease, regional axillary lymph nodes are involved in the process, which is manifested by symptoms of lymphadenitis: an increase and soreness of the lymph nodes, the inability to make limb movements due to pain.

As a rule, the development cycle of hidradenitis is two weeks, but at the same time, fresh purulent foci can be added to the already scarring nodes, which makes the disease potentially long and dangerous to human health. In this case, hidradenitis takes a chronic course with frequent and severe relapses, which requires a certain correction of treatment. With such protracted course comedones remain on the skin (fistulous passages connected to the surface of the skin by many holes).

Symptoms of complications of hidradenitis

With further progression of hidradenitis, it is possible to melt the tissues surrounding the sweat glands, which can manifest itself with a wide variety of symptoms, depending on the affected structure. Very often, the disease acquires a diffuse character and is accompanied by the development of phlegmon (unlimited purulent inflammation), which is clinically accompanied by the development of a severe intoxication syndrome (temperature rise to 40 ° C, headache, weakness) and the inability to make any movements of the affected upper limb. Another typical complication of hidradenitis is damage to the trunks of the brachial plexus, which is manifested by pain in the limb, a burning sensation along the nerves, and muscle weakness. The development of complications requires immediate hospitalization and the start of intensive treatment in a hospital.

It is very important to pay great attention to the prevention of hidradenitis and prevent the development of this disease.

Diagnostics

A doctor can prescribe treatment for any disease only after a visual examination, the patient undergoing additional instrumental examinations and obtaining the results. laboratory research. With a pathology such as hydradenitis, the diagnosis includes the following parameters:

• general blood analysis;
• sowing discharge;
• immunogram.

An important factor is differential diagnosis diseases. While the patient clinical manifestations seem obvious, and he is in a hurry to start treatment; an experienced qualified specialist will scrupulously study the data presented so as not to confuse hydradenitis with such pathologies as

• tuberculosis of the lymph nodes of the armpit;
• furunculosis;
• carbuncle;
• abscess;
• phlegmon;
• lymphadenitis.

If there are clear signs that indicate that hydradenitis is developing, diagnosis should be carried out in a medical institution. The attending physician will write out a referral for the necessary studies and prescribe a competent treatment.

Laboratory and instrumental research methods for hydradenitis

It must be remembered that the doctor signs not only the treatment plan, but also the types of diagnostics. The patient cannot choose the preferred research methods, add certain items or refuse to undergo examinations. As mentioned above, many diseases are manifested by symptoms similar to those of hidradenitis. But similar manifestations do not mean that the treatment will be similar. Therefore, incorrect diagnosis of pathology, at best, will lead to a protracted course of the disease, and at worst, to the development of numerous complications. In order to accurately diagnose hidradenitis, five main examination methods are used.

The study of the clinical picture of the disease. This point should be treated with particular care. External manifestations can both push for the correct diagnosis with obvious manifestations, and confuse the blurring of symptoms. On examination, the doctor will reveal a bluish-red hue and swelling of the skin of the affected area, and on palpation, dense painful formations in the form of nodes are determined. hallmark hidradenitis from other pathologies is the absence of a necrotic rod.

Assessment of the general condition of the patient's body. Patients may complain of a deterioration in well-being, lethargy, drowsiness, apathy towards the outside world, headaches and dizziness, and increased sweating. These signs are relative and can be a manifestation of many diseases. However, in a comprehensive examination, you should take into account all the details and pay attention to any little things.

General blood analysis. AT general analysis blood shows signs of inflammation: an increase in the erythrocyte sedimentation rate and an increased number of leukocytes.

Sowing discharge from the wound. Treatment of hidradenitis is not possible without antibiotic therapy. Therefore, it is advisable to culture the discharge from the wound to determine the sensitivity to these drugs. This measure will help to choose exactly the drug that will successfully eliminate the causative agent of the disease.

Immunogram. There are cases when prolonged and chronic hydradenitis is observed, the diagnosis in such a situation is supplemented by a study of the body's defenses. If the assumption about the weakening of the immune system is confirmed, the treatment is expanded by the introduction of immunomodulators.

Timely and high-quality diagnosis is an important step towards correct and adequate treatment.

Treatment

The method of treatment of hidradenitis depends on the stage of the disease. With the manifestation of a slight swelling, which has not yet had time to fester, you can get rid of the problem quite easily at home using external agents - antibiotic ointments and antiseptic solutions.

At an early stage of the disease, treatment with folk remedies is allowed, which is aimed at reducing inflammation and destroying pathogenic microorganisms on the skin. Also positive result show various methods physiotherapy.

Effective treatment for hidradenitis includes antibacterial therapy with antibiotics. Immunostimulating agents are also indicated, especially if relapses of the disease occur.

If the formations on the skin are festering, you can not do without surgical intervention. Does it hurt to cut hidradenitis? No, because this operation is carried out under the local or general anesthesia depending on the degree of skin damage. After removal of hidradenitis, it is important to follow all the recommendations of the surgeon and dermatologist in order to prevent repeated outbreaks of the disease. Also, for better healing of an open wound after surgery, local external therapy is indicated.

Can hydradenitis resolve? Of course, yes, if the treatment occurs in a timely manner and the correct drugs are used, which must be prescribed by a doctor.

How to get rid of hydradenitis at the initial stage?

How to treat hydradenitis under the arm or on any other part of the body, if only small seals have formed on the skin:

• antibiotic therapy - used for 8-10 days, depending on the patient's condition;
• antihistamines- used in case of severe itching;
• immunostimulating agents that are aimed at normalizing the protective functions of the body;
• specific immunotherapy - in cases frequent relapses diseases when the cause of inflammation is staphylococcus aureus;
• corticosteroids - are used in the form of injections that reduce the inflammatory process;
• external use of antiseptic and anti-inflammatory solutions;
• physiotherapy and dry compresses.

If you follow the instructions of doctors and use an integrated approach to solving the problem, hydradenitis resolves within 10-14 days.

How to treat hidradenitis - personal hygiene and skin care

How to cure hidradenitis quickly and without surgery? To do this, you need not only to take the drugs prescribed by the doctor, but also to follow the rules of personal hygiene with special care and take care of the inflamed areas of the skin.

First of all, cut off the hairs that are near the swelling with nail scissors. Also wipe the skin with antiseptics 4-5 times a day to prevent the spread of infection to neighboring sweat glands. If large areas of the skin are affected, ointments or injections with antibiotics and painkillers are prescribed.

The first days after the appearance of swelling, put gauze bandages on them, which must be soaked with antiseptics. Top can not be sealed with a plaster, which can create a greenhouse effect and worsen the situation. The use of wet compresses is also prohibited. This will only accelerate the suppuration of neoplasms.

Treatment of hydradenitis under the arm is best supplemented with dry compresses. To do this, apply a warm cloth to the affected areas of the skin or expose your hand to direct sunlight for 20-30 minutes daily.

During an outbreak of hidradenitis, it is not recommended to take a bath, which can lead to the spread of the disease to other areas of the skin. It is best to wash under the shower. At the same time, glue a bactericidal patch on the inflamed swelling. Also, during treatment, refuse to shave, so as not to provoke new outbreaks of the disease in other areas of the skin and not slow down the healing process.

Purulent hidradenitis - treatment

With the development of suppuration in places with swelling, all treatment is reduced to the use various means, which will help him to ripen, after which the hydradenitis is opened. To do this, it is best to use special ointments that are applied in a thick layer to the skin. This must be done until the moment when the abscess opens.

In parallel with external agents, it is necessary to continue the use of antibiotics, immunomodulatory drugs prescribed by the doctor.

When pus discharge appears in the middle of the seal, it is imperative to contact a surgeon who will remove the hydradenitis. You cannot open an abscess on your own. This can cause infection of the blood, which will lead to serious consequences.

Hidradenitis - surgical treatment

Surgery for hydradenitis is a necessary measure that will help eliminate abscesses and prevent the spread of the disease to other areas of the skin.

Depending on the nature of the disease, surgical intervention can take place according to the following schemes:

• the appearance of one abscess for the first time - the operation takes place under local anesthesia and last no more than 30 minutes. The surgeon opens the abscess, removes all the pus, and then treats the wound with antiseptics and antibiotic solutions;
• the formation of hydradenitis several times in the same place - during the operation, the entire inflamed sweat gland is removed;
• hidradenitis, which is accompanied by the formation a large number abscesses - the operation takes place in two stages under general anesthesia. This procedure is indicated in the most severe cases, which requires a long recovery period and strictly follow all the doctor's recommendations.

Treatment of hidradenitis in an intimate place, including surgery, occurs according to the same scheme that is used for other localization of abscesses.

Physiotherapy for hydradenitis

Together with other methods of treating hidradenitis, physiotherapy is used, which includes:

• UHF therapy - helps to reduce the inflammatory process and eliminate the abscess;
• UV therapy - destroys bacteria on the skin and increases resistance to infections;
• CMW therapy - improves blood microcirculation and eliminates inflammation;
• x-ray therapy - used to destroy the sweat gland, which is constantly inflamed.

Prevention of hidradenitis

An important point is the careful observance of hygiene standards:

• wear clothes made from natural fabrics, which should be loose and not rub anywhere;
• do not use daily antiperspirants. It is best to choose a powder with a bactericidal effect for yourself;
• change clothes and underwear every day, especially in summer;
• try not to shave with a razor. Preferably used laser hair removal or short cut hairs;
• take a shower daily;
• once a week for hygiene procedures, use antibacterial soap;
• for intimate hygiene, use special gels that contain lactic acid.

In order to prevent the formation of abscesses and inflammations that are characteristic of hydradenitis, it is necessary to systematically strengthen the immune system, monitor weight and treat other infectious diseases in a timely manner.

Medications

The choice of means and methods for the treatment of hidradenitis largely depends on the stage of the disease and the nature of its course. Yes, on early stages diseases dermatologists often prescribe their patients treatment with medications.

Surgical intervention is carried out only if the treatment of hydradenitis with ointments and tablets for a long time has not brought any results.

As a rule, a conservative technique consists in the treatment of hidradenitis with antibiotics. They can be used both internally and externally in the form of various ointments, creams, sprays, etc. However, in whatever form the medicine is, only a doctor can prescribe it. This is due to the fact that antibiotics for hydradenitis can be addictive, which in the future may adversely affect the effectiveness of therapy.

Good results in the treatment of the disease are also shown by ointments that have the ability to draw purulent contents out.

However, any medication should be prescribed by a specialist in the appropriate field. Only he knows which antibiotics for hydradenitis and ointments should be prescribed to a particular patient.

Vishnevsky ointment

Physicians are ambiguous about the use of Vishnevsky's ointment, because sometimes it speeds up the process of producing pus.

As part of this tool there is tar, camphor and Castor oil. These components of the drug have a slight irritating and warming ability.

After applying the product to the affected area, it warms up, and the blood supply in it improves. All this leads to the rapid development of the inflammatory process.

This means that Vishnevsky's ointment for hydradenitis is prescribed only if the pathology has already passed into the suppuration phase. In this situation, the essence of its application is to accelerate the process of opening the abscess. That is, ointment from hidradenitis is used not to suppress, but to enhance the inflammatory process.

However, in the initial stages of the disease, this medicine is still not advisable to use. That is why it is so important that Vishnevsky's ointment for hydradenitis is prescribed by a specialist.

A contraindication to the use of the drug is an allergy to the components of the drug.

Ichthyol ointment

Ichthyol ointment - another effective remedy with hydradenitis. It, like Vishnevsky's ointment, speeds up the opening process.

The agent showed the greatest effectiveness in the treatment of sluggish hidradenitis, in which the inflammatory process is weak, but at the same time prolonged. Usually, ichthyol ointment with hydradenitis, it is prescribed in combination with antibacterial drugs for oral administration.

Among the contraindications for the use this medicine you can note hypersensitivity to the components of the drug, pregnancy and lactation, age under 12 years.

Levomekol

Levomekol is an ointment that has antibacterial, regenerating and anti-inflammatory effects. It contains levomethicin (an antibiotic) and methyluracil. It is worth noting that in case of a severe course of the disease, the doctor may prescribe the administration of chloramphenicol in tablet form inside.

Since Levomekol is a remedy created on the basis of several drugs, accordingly, it can replace several medicines.

Levomecithin contained in the drug has a detrimental effect on staphylococci, streptococci, coli and many other bacteria. At the same time, methyluracil accelerates the process of tissue regeneration. In addition, it effectively simulates local immunity, so that the body eliminates the infection faster.

For the same reason, Levomekol is able to fight not only bacterial, but also viral infections.

Levomekol with hydradenitis is a relatively safe ointment. A contraindication to its use is only the presence of an allergic reaction to the constituent agents.

However, only a doctor should prescribe the ointment, as in some cases it can cause side effects, among which edema, rash, itching and redness of the skin can be distinguished.

If these symptoms occur, the patient should consult a doctor as soon as possible. When the drug is replaced, side effects disappear within a few days.

Erythromycin

Erythromycin for hydradenitis can be prescribed in different forms both in tablet and ointment form. The choice of the form of the remedy and the scheme of its use in this case is carried out by the doctor, based on the degree of the disease and the nature of its course.

This antibiotic can affect both Gram-positive and Gram-negative bacteria. Unlike antibiotics penicillin group erythromycin ointment for hydradenitis is much easier to tolerate by patients.

Erythromycin stops protein synthesis by pathogenic microorganisms, which leads to their death and a decrease in the inflammatory process.

Unfortunately, erythromycin (in any form), like most drugs, has its own contraindications. So, this tool is not recommended to use if the patient has intolerance to the components of the drug or severe liver disease. Pregnant women and children should consult a doctor before using the drug.

Among side effects the drug, patients sometimes report dizziness, swelling, migraines and shortness of breath.

Dimexide

Dimexide is a drug for external use that has anti-inflammatory, antibacterial and mild analgesic effects.

Dimexide has a low price, and you can buy it at any pharmacy.

Its main function is to conduct other medicines into the deeper layers of tissues, that is, it acts as a conductor.

However, you can use this tool only as directed by a doctor, since if used incorrectly, it can cause a chemical burn or pass into the body along with useful substances and toxic.

Pregnant women and patients with liver and kidney diseases should refrain from using dimexide for hydradenitis.

Among side effects drug, patients often report nausea, allergic reactions, respiratory disorders and burning sensation.

As a rule, the doctor selects for the patient individually the medications that must be used with Dimexide to achieve the best results. To do this, the patient must independently make various talkers and ointments with dimexide in the composition. It is important not to self-medicate. Only a doctor knows exactly how to smear hydradenitis to his patient.

Amoxicillin

Amoxicillin is an oral antibiotic. It effectively fights pathogenic bacteria - causative agents of hydradenitis.

Its absorption in the stomach occurs within 15-30 minutes after ingestion. It reaches its maximum activity after 2 hours, and the duration of its action is 8 hours.

Among the side effects of amoxicillin are allergies, digestive disorders, and central nervous system damage.

Folk remedies

In addition to the official approach in the treatment of hidradenitis, it is effective and ethnoscience. But at the same time, it is worth remembering that this inflammatory process is a serious ailment, so the selection of a folk remedy should be carried out after consulting a doctor.

Aloe disinfection

Treatment of hidradenitis at home is effective when using the leaves of this houseplant.

For the procedure, perennial aloe is used, which must be washed with water before use, the thorns are removed. A cut sheet is applied to the site of inflammation for 20 minutes several times a day. The medicinal juice of the plant draws out pus and promotes the rapid healing of inflammation.

Compresses from blackberry leaves, plantain and white cabbage are also suitable for cleansing an abscess.

Treatment with onions

With purulent rashes, baked onions are effective. The vegetable is cut into half rings and baked in the oven until golden brown. Then the agent is applied to the sore spot, fixed with sterile cotton and bandaged.

Treatment must be continued until the rupture of the abscess.

Honey and propolis

Alternative treatment of hydradenitis involves the use of honey and propolis in the absence of allergies.

If there are no special contraindications, then bee glue and honey are mixed, and there should be a little more propolis in medical composition. Wheat flour is added to the folk remedy. The resulting cake must be applied to the diseased area, secured with adhesive tape.

Sour cream and rye flour

For a compress with hydradenitis, fatty sour cream and flour are used. The resulting mass should be dense, it is important that the substance does not slip from the place of attachment.

Eggs, honey and flour are also used for the compress. All components are mixed into a homogeneous composition and applied for several hours to the site of inflammation.

To fix the flour cake, you also need an adhesive plaster.

Herbal remedies

For a complete cure for the disease, it is effective to take medicines inside. In this case, phytotherapy comes to the rescue.

Calendula tincture is also suitable for treating an inflamed area. A little water is added to the solution before use.

To accelerate the maturation of the abscess, an infusion of wormwood paniculata is used. The boiled product cools, the diseased areas are lubricated with medicine.

With hydradenitis, a herbal collection of eucalyptus and plantain leaves, calendula and elderberry flowers is effective. All plants are taken in equal proportions. One glass of raw materials is crushed and poured with water, the mixture is brought to a boil over low heat.

The medicine is used several times a day after insisting in a dark place. For taste, you can add a teaspoon of honey to the broth. This folk remedy for hydradenitis has anti-inflammatory properties and improves immunity.

To heal a burst abscess

To make the wound heal faster, wash the sore spot with infusion of chamomile or sage. This will not only reduce inflammation, but also relieve pain.

It is strictly contraindicated to squeeze out an abscess. This can lead not only to redness and expansion of the inflammatory area, but also to blood poisoning (sepsis). This condition is life-threatening and requires urgent hospitalization.

Although folk remedies have a certain therapeutic effect, but a conservative approach is not a panacea for hidradenitis. With inflammation, surgical intervention is often indicated, so you cannot prescribe treatment yourself. Running the disease is also not an option, since hydradenitis can go into the stage of severe suppuration.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Axillary hydradenitis develops as a result of purulent inflammation of the apocrine glands located in the armpits.

The reasons

The main reason for the development of hidradenitis is the pathogen entering the excretory duct of the apocrine gland - Staphylococcus aureus. However, the entry of staphylococcus occurs only if there are predisposing factors:

• increased sweating;
• the presence of microtraumas of the skin resulting from careless shaving, scratching;
• weakening of the body's defenses (decreased immunity);
• non-compliance with the rules of personal hygiene;
• endocrine diseases such as diabetes mellitus, exogenous constitutional obesity.

Hidradenitis, localized under the armpit, occurs more often in women than in men.

In old age, the occurrence of hidradenitis practically does not occur, since at this age the sweat glands already function poorly.

Signs of hidradenitis

The process is most often unilateral, in rare cases there may be a bilateral lesion.

At the beginning, hydradenitis is represented by small dense single nodules, they are located immediately under the skin. When they are palpated, the patient feels a slight soreness.

With further progression of the disease, the nodules increase in size, they can be from 5 mm to 3 cm in size. As the size of the nodes increases, their soreness increases.

Pain in the armpit are aggravated by movement. The nodules are soldered to the skin, from this the skin becomes cyanotic.

Symptoms of intoxication of the body may be present:

• increase in body temperature;
• general weakness;
• headache.

Large nodes tend to merge with the formation of a dense infiltrate of large size. Pain also occurs when bringing the hand to the body.

After 4-5 days, softening occurs in the center of this infiltrate and the purulent formation opens. The discharge is purulent, thick, sometimes there may be a small amount of blood impurity.

After opening the patient, pain in the axillary region decreases, body temperature decreases, and general well-being improves.

Healing occurs with the formation of scar tissue.

If hidradenitis is not treated, then a relapse of the disease occurs.

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Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute

Diagnostics

Diagnosis of axillary hidradenitis is based on clinical picture diseases, characteristic changes in the armpit area.

A surgeon can make an accurate diagnosis.

Unlike boils (inflammation of the hair follicle), with hydradenitis, a necrotic rod does not form.

In a general blood test, signs of inflammation are found:

• an increase in the number of leukocytes (leukocytosis);
• the erythrocyte sedimentation rate (ESR) increases.

In case of recurrent or prolonged course of hidradenitis, the discharge from the wound is sown, it is determined to which antibacterial drugs sensitive pathogen.

Treatment of hidradenitis

Axillary hidradenitis is treated by a surgeon, but in the initial stage of the disease, you can contact a general practitioner or general practitioner.

If treatment is started in the early stages of the disease, it can be cured without surgical intervention and avoid complications.

Treatment is divided into general and local.

To general treatment applies to:

• taking antibiotics: flemoclav, erythromycin, ampicillin;
• with severe pain, painkillers are prescribed: nimesulide, ketorol, meloxicam.

With a recurrent course of hidradenitis, immunostimulating therapy is carried out, it is carried out strictly according to the prescription of the immunologist, after the examination.

With a protracted course, autohemotherapy can be carried out in order to increase the body's defenses: the patient's own venous blood is injected subcutaneously or intramuscularly.

Local treatment includes:

• ultraviolet irradiation of the axillary region;
• UHF treatment.

Treatment of hydradenitis at home

At home, at the initial stage of the disease, warming procedures with dry heat can be performed. To do this, a bag of salt heated in the oven or a hot boiled egg is applied to the armpit 2-3 times a day.

handle skin antiseptic solutions: alcohol, brilliant green solution, alcohol solution salicylic acid, boric alcohol.

Vodka compresses are recommended at the stage of infiltrate formation (“suppuration”). To do this, make a solution of water and vodka 1: 1. Apply a compress for 20-30 minutes.

Ichthyol or Vishnevsky ointment is also applied when a softening area appears in the center of the infiltrate.

Surgery

If conservative therapy fails, then surgery at the stage of softening of the center of the infiltrate. In this case, the abscess is opened with the removal of purulent contents. Then daily dressings are made using antiseptic solutions (chlorhexidine, miramistin), you can put Baneocin antibacterial powder inside the wound.

Attention! It is impossible to open or squeeze out a purulent formation yourself.

During the illness, the consumption of spicy foods, smoked meats, seasonings, and alcoholic beverages should be avoided. It is recommended to take a multivitamin.

Hidradenitis is treated on average 10-14 days.

Possible Complications

Spread to the subcutaneous fat with the development of soft tissue phlegmon. This process develops with untimely or incomplete treatment. With proper treatment and compliance with all the doctor's recommendations, it rarely develops.

Entering the pathogen from the wound into the bloodstream and spreading the infection throughout the body can cause sepsis. It develops when the patient tries to open the infiltrate on his own.

Prevention of hidradenitis

• Compliance with the rules of personal hygiene.
• Careful hygiene of the axillary area with excessive sweating.
• Weight loss in obesity.
• Refusal of irritating perfumes and deodorants.
• Shaving your armpits with care.
• Treatment of the armpit area with antiseptics (chlorhexidine, miramistin) with a high tendency to develop hidradenitis, recurrent course.

With timely and competent treatment, the prognosis of the disease is favorable. If signs of illness appear, you should immediately consult a doctor.