Acne inversa

Question 1

Hidradenitis suppurativa (acne inversa)

Answer 1

• chronic, painful, inflammatory skin disorder
• more common < 40 years
• women > men
• suspect in pubertal/post-pubertal patients with diagnosis of recurrent furuncles or boils

Question 2

Features of acne inversa

Answer 2

• inflammatory nodules, pustules, sinus tracts, and scars
• in intertriginous (body folds) areas - axilla most common
• nodules may rupture, discharging purulent, malodorous materia
• coalescence of nodules can result in ‘rop-like’ scarring

Question 3

Risk factors for acne inversa

Answer 3

• fmaily history
• smoking
• obesity, diabetes, PCOS
• mechanical stretching of skin

Question 4

Management of acne inversa

Answer 4

• good hygeine, loose clothing
• smoking cessation, weight loss
• steroids or flucloxacillin (flare ups)
• topical or oral antibiotics (long term)
• surgical excision of persisting lumps

Question 5

Complications of acne inversa

Answer 5

• sinus tracts, fistulas
• comedones
• scarring
• contractures
• lymphatic obstruction