Hydradenitis in an intimate place. How to treat the disease "bitch udder", what to do at home

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 conditions;
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 too 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 hygiene rules 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. With proper treatment of 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 is a frequent complication of recurrent hidradenitis, which can 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 of acne. Hidradenitis can sometimes appear on the face or neck.

The causes of this skin condition are considered to be 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 \u200b\u200bthe skin becomes bluish. 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 condition 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?

Hidradenitis is a rather dangerous disease, since 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 the similarity of symptoms in different people. It is very important to note that if any of the symptoms described below appear, a person should immediately contact a medical institution for 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 a general inflammation of the subcutaneous tissue, which can make it difficult to differentiate 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 a 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 of laboratory tests. With a pathology such as hydradenitis, the diagnosis includes the following parameters:

general blood analysis;
sowing discharge;
immunogram.

An important factor is the differential diagnosis of the disease. While the clinical manifestations seem obvious to the patient, and he is in a hurry to begin 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. A distinctive feature of 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. In the general blood test, signs of inflammation appear: 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, various methods of physiotherapy show a positive result.

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 performed under 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 of frequent relapses of the disease, when staphylococcus aureus is the cause of inflammation;
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 your 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 comes down to the use of various means that will help it mature, after which 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 lasts 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 of a large number of 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. It is preferable to use laser hair removal or cut hairs short;
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. So, in the early stages of the disease, dermatologists often prescribe medication to their patients.

Surgical intervention is carried out only if the treatment of hidradenitis 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.

The composition of this tool contains 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 is another effective remedy for 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. As a rule, ichthyol ointment for hydradenitis is prescribed in combination with antibacterial drugs for oral administration.

Among the contraindications to the use of this medication, hypersensitivity to the components of the drug, pregnancy and lactation, age under 12 years old can be noted.

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 drug based on several drugs, it can replace several drugs accordingly.

Levomecithin contained in the drug has a detrimental effect on staphylococci, streptococci, Escherichia 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, since in some cases it can cause side effects, among which swelling, 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 administered in various forms, both in tablets and in the form of an ointment. 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 of the 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 the side effects of the drug, patients sometimes note dizziness, swelling, migraines and difficulty breathing.

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 drugs 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 carry into the body along with beneficial substances and toxic ones.

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

Among the side effects of the drug, patients often note 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 hydradenitis, traditional medicine is also effective. 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 the therapeutic 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, a conservative approach is not a panacea for hydradenitis. 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.

Hydradenitis under the arm or in the groin is a purulent inflammation of the apocrine sweat glands. The disease has a gradual development. At the initial stage, the appearance of a painful nodule in the size of a pea is noted.

What is hydradenitis

Hydradenitis by origin is an inflammatory disease that begins to develop under the influence of a certain pathogen in the body.

Over time, the node can increase in diameter up to 2-3 cm and become pear-shaped. The resulting abscess resembles a nipple in appearance, which is why the disease is popularly called "bitch's udder".

According to statistics, inflammation most often occurs in the armpit. In some cases, the disease develops in the groin, labia minora in women, around the anus or nipples.

The main causative agent of hidradenitis is the ingestion of Staphylococcus aureus. At the same time, there were isolated cases of infection with ordinary streptococci or Escherichia coli.

The causative agent most often enters through the skin, but in some cases, infection has been recorded by transmitting bacteria through the lymph in the acute course of diseases such as chronic tonsillitis, otitis media, and gynecological pathologies.

Hydradenitis does not occur in children before adolescence, since the work of the apocrine glands is activated only in puberty. The peak incidence occurs in men and women aged 18–35 years, since during this period the most active activity of sweating in the body is noted.

In some cases, hydradenitis can be inherited. This trend is due to the peculiarities of the physiological structure of the apocrine glands. In combination with this disease, an epithelial coccygeal passage, abscessing acne, is also common.

ICD code 10

Hidradenitis is classified as a purulent inflammatory disease, therefore the international classification of diseases defines a special code for this pathology L 73.2

Diseases indicated by the letter L are classified in class 7 (diseases of the skin and subcutaneous tissue). This information is necessary to fill out medical documents and the medical history of a sick patient, as it helps to quickly decipher the diagnosis for an experienced specialist.

The structure of the skin and sweat glands

The human skin has a large area (about 2 sq. m) and consists of three layers that perform certain functions in the body.

The epidermis, which has a thickness of about 1 mm and consists of 5 layers of cells differing in structure. The bottom layer contributes to the development of new cellular structures necessary for skin renewal. The top layer contains dead horny cells that perform a mechanical function and prevent pathogens from entering deep into the epidermis.
The skin (dermis) consists mainly of connective tissue and has two layers:

The papillary layer, which is located under the epidermis, where the nerve endings and loops of blood vessels are located;
Mesh layer with connective tissue, blood, lymphatic vessels, nerve endings. In the thickness there are also hair follicles, sebaceous and sweat glands, collagen and muscle fibers that provide elasticity and firmness of the skin.

Subcutaneous fat (hypoderm). Among the bundles of connective tissue are accumulations of fat cells. This layer provides a protective function (severe damage, temperature changes, providing a supply of nutrients).

Skin appendages are nails, hair and sweat glands.

Detailed consideration is provided in the list below.

The sebaceous glands are the producers of sebum. In this case, a protective lipid layer is formed that prevents water from getting inside along with the content of pathogenic microorganisms. The glands are located in the surface layer and have a structure in the form of cells. The total number reaches 3.5 million, and about 20 grams of subcutaneous fat is produced during the day.
Sweat glands produce sweat and have a special structure in the form of unbranched tubes that are located deep into the dermis. The excretory duct is a straight tube that carries fluid to the outside. Their total number reaches up to 2.5 million. At an average temperature, the volume of sweat released is about 800 ml and 40 grams of salt.

Classification of sweat glands:

Eccrine sweat glands produce a clear-colored sweat and are located throughout the body. A larger number is scattered in the area of the palms, feet, back, chest. The secreted liquid consists of water with impurities of lactic acid. The active work of the glands begins with a strong overheating of the body for normal thermoregulation in the body;
Apocrine sweat glands are located in the armpits, nipple halos, groin, and anus. The excreted sweat has a thicker consistency with a pronounced odor, as it contains impurities of fat and cholesterol.

Scientists believe that the apocrine glands secrete the so-called pheromones, which affect the hormonal background and attract the opposite sex. With strong sweating on the skin, favorable soil is formed for the development of pathogenic microorganisms and an increase in unpleasant odor.

The activation of the apocrine glands occurs with severe overheating of the body, a nervous breakdown, or during the menstrual cycle. Therefore, hydradenitis often occurs in places of increased sweating with the successful development of pathogenic microorganisms on the skin.

The development of hydradenitis in the armpits is most often diagnosed with increased sweating in the armpits, since a favorable environment is formed for microorganisms, which ensures their further penetration into the body. When they enter the mouth of the hair follicle or the lymphatic ducts, an acute inflammatory process begins to develop.

Hidradenitis in the armpits can also develop in the absence of proper hygiene or in the presence of pathological diseases in the body (diabetes mellitus, endocrine disorders, third and fourth stages of obesity).

The accelerating processes for the formation of pathology are the appearance of increased acidity in the excreted sweat and a sharp decrease in immunity in the body.

Hydradenitis formed in the inguinal zone

Hydradenitis in the groin is formed quite rarely, but it is no exception. Most often, the cause of inflammation is considered non-compliance with personal hygiene during and after sexual intercourse.

Most sick patients immediately consider characteristic manifestations as a sign of sexually transmitted diseases. But only a doctor can make an accurate and correct diagnosis. In the absence of treatment or improper therapy, inflammation penetrates the genital organs and can lead to a purulent course with acute symptoms.

Hydradenitis in the groin in women

Hydradenitis in the groin in women can occur for various reasons in the genital area or the anus, where the apocrine glands are located. The disease is most often diagnosed in the summer, when the average temperature exceeds normalized levels.

The disease can form on the small and labia lips and have various degrees of course: acute, complicated and chronic. With a pronounced course, fistulas are formed, which subsequently become fibrous scars and contribute to the formation of a permanent relapsing form.

Hydradenitis during pregnancy

Hidradenitis during pregnancy can develop due to a sharp decrease in immunity and hormonal imbalance. The body is undergoing serious changes, and withstand a double load, as it ensures the vital activity of both systems.

This disease is quite serious and can have various consequences for the woman and the unborn child. The treatment regimen is also not simple, since in this case it is necessary to prescribe antibiotic drugs that are contraindicated for the fetus.

In the treatment of hidradenitis, it is necessary to pay attention to the following therapeutic measures:

Regular treatment of the site of inflammation with an antiseptic or alcohol solution;
The ban on taking baths, as it is best to bathe under running water;
Compliance with preventive measures prescribed by the attending physician.

In exceptional cases, surgery is required, which is carried out in several stages (making an incision, subsequent drainage and ensuring further healing).

As a preventive measure, doctors may prescribe local drug therapy (washing the wound with an antibiotic to eliminate re-infection).

The presented photo clearly shows the visual manifestation of hydradenitis in the armpit. The disease is characterized by the appearance of inflammation in the form of a small formation that has a red color and indicates an acute course of the disease.

A purulent process develops inside the hair follicle, which causes additional signs of intoxication of the body (fever, fever, chills). If suspicious symptoms appear, it is necessary to immediately go to the hospital and prescribe the correct treatment regimen.

The main causes of the disease

The formation of hidradenitis is possible in the presence of three provoking factors:

The presence of a pathogen on the skin;
Decreased protective properties of the skin;
Weakening of the immune defense in the body.

Population by staphylococci

The main reason for the appearance of hidradenitis is the settlement of the ingestion of staphylococcus aureus. In this case, the pathogenic microorganism has the following varieties:

Staphylococcus epidermidis, which develops on the skin and mucous membranes of a person. It is present in the opportunistic flora and can cause pustular diseases with a sharp decrease in immunity;
Saprophytic staphylococcus is also present in the human body. This bacterium often causes urethritis or cystitis in women;
Staphylococcus aureus is considered a dangerous bacterium, as it provokes serious diseases in the body (tonsillitis, pneumonia, sepsis). In 20% of people, the bacterium lives in the body and does not develop into any pathology.

Most people have an increased sensitivity to staphylococcus, therefore, diseases with a severe course develop in the body (hydradenitis, phlegmon, furuncle, enterocolitis, pericarditis, sepsis).

A dangerous property of staphylococcus is the ability to release toxins in the body, since these substances break down the connective tissue and change the quantitative content of red blood cells, white blood cells.

properties of the skin

The formation of hidradenitis is affected by changes in the properties of the skin, which are discussed in more detail in the list below.

Change in alkalinity of the skin. A healthy person is characterized by the presence of a slightly acid reaction pH 4–5.6, which contributes to the formation of normal microflora. If the indicators decrease, then the development of pathogenic bacteria begins, provoking the formation of hydradenitis in the future.

Acidity decreases under the influence of provoking factors:

Use of alkaline cosmetics in skin care;
Reception of sodium bicarbonate;
The use of baking soda in diet and cosmetic procedures.

To normalize the level of acidity, it is best to use products that have a low pH level and contain lactic acid.

Excessive activity of the sweat glands. With such symptoms, there is compression of the excretory duct and accumulation of sweat under the skin. As a result, a favorable environment is created for the development of pathogenic microorganisms.

Excessive sweating can occur for the following reasons:

The state of the immune system

A sharp decrease in immunity is possible with the development of various factors, discussed in detail in the list below.

Severe depletion of the body, which can occur with excessive physical and nervous stress, infectious diseases, operations, injuries, insomnia, burns, blood loss, chronic stress.

With reduced immunity, the body produces a small amount of leukocytes and lymphocytes, which protect the body from penetrating infections.

Chronic diseases (herpes, AIDS, tuberculosis, viral hepatitis, helminthiasis, toxoplasmosis). Pathogens penetrate the body, which poison the body and contribute to its further intoxication.
Long-term use of drugs of medicinal origin (cytostatic drugs, hormonal agents, antibiotics). These substances provide a decrease in the production of lymphocytes and leukocytes.
Congenital diseases affecting the immune system (hereditary neutropenia, combined immune deficiency, X-linked agammaglobulanemia).

The above diseases are formed during the period of intrauterine development of the fetus. In this case, there is an insufficient production of lymphocytes and leukocytes or a violation of their functionality.

Autoimmune diseases (scleroderma, rheumatism, systemic lupus erythematosus). With the development of pathology, own cells reject their own structures, which leads to a decrease in immunity.
Violation of the diet and metabolism. A sharp decrease in immunity may be due to a lack of proteins and useful trace elements with prolonged dieting. Pathologies formed during abnormal metabolic processes (hypothyroidism, diabetes mellitus, stages of obesity).
Decreased immune defense at various life periods:

Low immunity in childhood is due to insufficient functionality of vital systems;
Age-related changes also affect the decrease in immunity due to a pronounced slowdown in metabolism;
Pregnancy, since during this period the activity of immunity is minimal due to the development of the fetus.

The procedure of hypothermia contributes to vasospasm and a decrease in the activity of leukocytes. As a result, metabolic processes slow down, which leads to the formation of the disease.
development of anemia. A decrease in hemoglobin levels causes oxygen starvation, which affects the general state of immunity.

The mechanism of development of hydradenitis is carried out when the following factors occur:

Formation of a horny cell;
Expansion of the duct and gland formed under the pressure of sweat;
Reproduction of bacteria in the gland and activation of the inflammatory process;
The formation of a wall of connective tissue that limits the cavity, which is filled with pus;
Deposition of fibrin on the walls of the cavity and the formation of fistulous passages.

Where is hydradenitis most often formed?

Hidradenitis can form at the locations of the apocrine glands:

Armpits;
Inguinal region (anus, perineum, labia majora, scrotum);
Halos around the nipples;
Hairline of the head.

Pathology is formed in the places described above for the following reasons:

The main symptoms of inflammation

Symptoms of hidradenitis make up a pronounced clinical picture of the disease and are discussed in detail in the list below:

The formation of a dense knot at the site of inflammation with a diameter of 3 mm to 2 cm. In parallel, pain and itching occur;
The appearance of severe inflammation in the form of a nipple with pus that wants to break out;
The formation of blackheads around the inflammation, as the sebaceous glands are clogged with a horn plug. These symptoms indicate that the disease is spreading;
The appearance of a red-blue color in the area of inflammation, as the accumulated capillaries burst and contribute to a bluish tint;
Severe swelling, which is caused by squeezing of blood vessels and nerve fibers;
The formation of a flat infiltrate (accumulation of lymph and blood cells). The area of the skin becomes dense and causes pain even at rest;
General intoxication of the body, which is expressed by nausea, vomiting, fever, headaches;
The formation of a cavity filled with pus. The knot becomes soft, and when pressed, rolls under the skin. This property distinguishes hydradenitis from the resulting boil;
Opening of suppuration, which can occur spontaneously when pressure is created. As a result, pus with blood impurities is released, and the general condition improves markedly.

Which doctor to contact

The initial stage of development of hidradenitis involves an appeal to a dermatologist who will conduct a survey and examine the site of the lesion. If there is a severe course and the formation of an abscess, then the assistance of a surgeon is required to perform an autopsy.

After the surgical operation, drainage is established and therapy is prescribed for recovery in the postoperative period.

Diagnostics

Diagnosis of hidradenitis is based on a visit to a doctor who conducts an examination and finds out the necessary information:

The time of appearance of the seal;
The presence of pain and itching;
The speed of increasing the site;
Temperature rise;
Assessment of the general condition;
Finding out the presence in the anamnesis of previously transferred hidradenitis.

Conducting a survey to identify concurrent diseases that may affect the formation of hidradenitis.

Inspection of the site of inflammation is carried out in order to clarify the following symptoms:

The formation of an abscess in the form of a pear or nipple;
The appearance of a shade of red-blue hue;
Hot and swollen skin at the site of inflammation;
The presence or absence of an infiltrate;
Wavy fluctuation of pus inside the cavity;
The formation of an ulcer at the site of the opening of the abscess;
Swelling when squeezing the lymph.

The main study in the diagnosis of hidradenitis is a bacteriological study (study of the fluid to identify the pathogen). The necessary material is taken at the opening of the abscess.

Treatment Method

The method of treatment of hidradenitis consists in the use of complex measures. Experts recommend performing such therapeutic measures.

Immunity Boost

In order to increase immunity, it is necessary to follow a diet and minimize the intake of foods that affect the process of sugar absorption:

The following foods should predominate in the diet:

Fruits and vegetables in fresh and processed form;
Vegetable oils without prior purification;
Brewer's yeast, as they contribute to the normalization of the acid-base balance;
Products with a protein content (meat, fish, legumes), as they are the basis for creating immunity and contain essential amino acids and beneficial trace elements;
Sour-milk products (kefir, cottage cheese, sour cream, fermented baked milk) contribute to the normalization of the intestinal odds;
Foods high in iron (apples, spinach, Brussels sprouts, beef, lamb, shellfish, egg yolks);
Reception of vitamin complexes of groups A, B, C, E, folic and nicotinic acid.

Keeping a sleep and physical activity schedule

Each person should sleep at least 7-8 hours a day, preferably at the same time, as the body sets its own biorhythms and establishes the normal functioning of vital systems.

In the acute course of the disease, doctors recommend limiting physical activity and sports, as the disease can spread to other areas of the skin. After recovery, it is required to lead a moderately active lifestyle and perform simple daily exercises.

As physical activity, you can use simulators, sports running, gymnastics. For hardening, it is good to take a contrast shower 2-3 times a week.

To increase immunity, it is important to exclude severe stress and nervous disorders, so you can do yoga or other calming meditations.

Treatment during the first 3 days

In the treatment of hidradenitis, drug therapy is used using drugs of various categories. The basis is the prescription of antibiotics, detailed in the table below.

A number of antibiotics	Name	Mechanism of influence	Application
Tetracyclines	Tetracycline, Vibramycin	Active ingredients block protein synthesis and prevent further development of pathogenic microorganisms	250 mg 4 times a day or 500 ml three times a day
Macrolides	Erythromycin	This group of antibiotics is well tolerated. Gets into the skin and is highly concentrated, which ensures high drug efficacy	1 or 2 tablets every 6 hours no more than 4 times a day
Cephalosporins	Cefalexin	The active substance of the composition affects the cell structures of bacterial membranes and destroys them	Up to 2 grams per day every 12 hours for 14 days
Lincosamides	Clindamycin	The preparations contribute to the destruction of pathogenic microorganisms causing the development of hydradenitis	The medicine is presented in the form of a solution for the implementation of lotions.

The following drugs are prescribed as additional drugs:

Antihistamines to relieve swelling (1.2 tablets per day);
Injections of hormonal drugs to relieve inflammation. The reception scheme is assigned individually;
Isotretinoin is prescribed during surgery to speed up healing;
Means of immunostimulating action to increase immunity (tincture of echinacea, ginseng). Dosages are prescribed in the instructions for use;
Conducting specific immunotherapy is prescribed for frequent inflammations of hidradenitis (staphylococcal immunoglobulin, antifagin, T-activin).

Disinfection of the skin around the inflammation

The exclusion of the process of further spread requires disinfection of the skin around the resulting inflammation:

Observance of certain hygiene

Personal hygiene helps prevent the spread of the disease to other organs:

Availability of personal towels, bed linen. After washing, everything must be ironed with a hot iron;
Avoid taking warm or hot baths. In this case, it is recommended to take a contrast shower;
The use of bactericidal soap with lactic acid to normalize the acidity of the skin;
Treatment of the affected area after washing with a weak solution of potassium permanganate;
The prohibition of shaving or epilation until complete recovery;
Wearing loose clothing made from natural materials that will not interfere with inflammation;
Use of powders containing talc and zinc oxide.

Appointment of compresses, warming up and physiotherapy procedures

Compresses and heating can be prescribed individually after a thorough study of the presented clinical picture. Also, physiotherapy procedures are effective:

Sunbathing or warming up using an ultraviolet lamp for 5 minutes while maintaining a distance of at least 20 cm;
The use of ultrahigh-frequency therapy helps to soften the dense infiltrate;
Local ultraviolet irradiation helps to destroy pathogenic bacteria and strengthen immunity;
Centimeter therapy ensures normal blood circulation, reduces inflammation, increases the protective properties of the skin;
X-rays are used to destroy an inflamed sweat gland.

With the formation of a cavity with pus, warming procedures are prohibited.

Treatment after 3 days and the possibility of surgery

After 3 days, the cavity is filled with pus, there is increased soreness, which does not go away even at rest.

Treatment of hidradenitis is based on the procedures for the maturation of the abscess. In this case, ichthyol is applied to the site of inflammation, and a thin layer of cotton wool is applied on top. Triamcinolone injections are also prescribed.

After the abscess matures, it is necessary to contact the surgeon, who will carry out the necessary manipulation. Independent autopsy is fraught with serious consequences in the form of sepsis, blood poisoning, suppuration in the internal organs.

Surgical intervention is carried out using three techniques, discussed in detail in the list below.

Representation of hidradenitis by the presence of one abscess. The site of inflammation is anesthetized with Lidocaine injections. The wound is washed with an antiseptic solution and a drain is installed for further cleansing of pus.

The operation lasts about 20 minutes, and after the patient is discharged home with mandatory observance of rehabilitation procedures. The healing process averages 5-7 days.

Repeated inflammation of hidradenitis in the same place. In this case, the surgeon excised the damaged sweat gland along with fistulous tracts and fibrous nodes. After that, a bandage is applied with Vishnevsky ointment or synthomycin emulsion.
Inflammation with hydradenitis and the formation of a large number of small abscesses. With such indications, an operation is performed under general anesthesia and subsequent excision of the fiber. At the second stage, all areas of the affected tissue are removed and the tissue is transplanted from another part of the body

After the manipulation, the wound is treated with Lassar paste or zinc ointment and a gauze bandage is applied in several layers. Healing occurs after 7-10 days.

If you do not consult a doctor, then the resulting abscess can open on its own. Then a reservoir is formed, which will periodically worsen, which will lead to the appearance of a chronic form of hydradenitis.

Prevention

Prevention of hidradenitis is based on the observance of a certain number of recommendations:

Systematic strengthening of immunity;
Elimination of foci of chronic infection (otitis media, tonsillitis, pharyngitis, gynecological diseases);
Compliance with personal hygiene.

To exclude the development of hydradenitis, it is necessary to follow some tips on personal hygiene:

Wearing clothes made from natural fabrics, as synthetics injure the skin and can cause inflammation;
Regular change of clothes;
Exclusion of the use of antiperspirants, as they block the sweat glands;
Frequent shaving or hair removal is undesirable, as it can contribute to the formation of hidradenitis;
Taking a contrast shower at least 2 times a day;
Using Nizoral shampoo or other antiseptic once a week for prevention;
Prohibition of the use of hard washcloths;
Daily use of a shower gel containing lactic acid;
Taking baths with medicinal decoctions of antiseptic action (oak bark, chamomile, calendula).

Cost of treatment

The cost of treating hidradenitis depends on the severity of the disease and the general condition of the patient. The price range varies between 5000-40000 thousand rubles.

If inflammation is not started, then at the initial stage the procedure will cost about 15,000 thousand rubles. The pricing policy also depends on the region of the country where the medical facility is located.

Hydradenitis in the groin in women occurs as often as in the armpit. The disease is associated with inflammation of the apocrine glands due to the penetration of pathogens. Symptoms are unpleasant, but with timely access to a doctor, you can quickly get rid of them. With the transition of the disease to the chronic stage, treatment is delayed for weeks.

Hidradenitis is a disease associated with apocrine sweat glands. There is a blockage of the ducts, the penetration of bacteria and the formation of painful purulent nodes. Localization on the body can be in any place where there are sweat glands, but most often the armpit and groin area suffers. The people call the disease a bough udder because of the similarity of abscesses with the nipples of dogs.

Inflammation in the groin in men can affect the scrotum, anus, genital folds. In women, the nodes are most often localized on the labia. Only the labia majora is affected, as there are no sweat glands on the minor lips. There is a violation of the process of sweating, apocrine channels are clogged, pus begins to accumulate.

By the nature of the course of the disease, hydradenitis is similar to boils. A distinctive feature is the absence of a central rod. Bacteria enter the ducts of the sweat glands through hair follicles, abrasions on the surface of the skin, or from infected internal organs.

The cause of the inflammatory process is most often Staphylococcus aureus or bacteria of the streptococcal group. Factors provoking the onset of the disease:

decreased immunity due to frequent colds, insufficient sleep, poisoning, stress;
diseases of the endocrine system affecting the thyroid gland, adrenal glands, pituitary gland;
disruptions in the hormonal background during pregnancy, menopause, inflammatory processes occurring in the genitals;
increased sweat formation;
skin diseases (dermatitis, allergic manifestations);
malnutrition (lack of vitamins, starvation, vegetarianism);
wearing tight underwear made of synthetic fabrics;
side effects from taking certain medications (most often antibiotics, hormonal agents, immunosuppressants);
non-compliance with hygiene rules.

Shaving the intimate area can increase the risk of developing hydradenitis, during which abrasions and scratches may remain.

If you do not start treatment, then complications of hydradenitis on the labia develop. An abscess of the soft tissues of the genital organs may develop, phlegmon is formed in the small pelvis, thrombosis of the small pelvis and lower extremities develops.

The manifestation of the disease

Symptoms of inguinal hidradenitis bring a lot of inconvenience. The disease can be life-threatening, so you need to know the signs:

On the first day, a small reddish-colored seal appears, which hurts and itches.
After a couple of days, the seal becomes large, it can reach a diameter of 2 cm, the color is red-burgundy. The pain bothers not only during movement, but also at rest. There are cases of a rise in body temperature up to 39 degrees. Weakness, dizziness join, sleep is disturbed.
Next to the main inflammatory focus, other nodes appear, which gradually merge.
The area of edema and inflammation increases, the pus in the nodes becomes even larger, the color is maroon. Sometimes, under the pressure of pus, the abscess opens, as a result of which the person's condition improves.
After opening, a bleeding and festering wound is formed, which gradually shrinks. A scar appears at the site of the wound.

You can not squeeze out pus on your own. The infection can spread to neighboring tissues and organs, get into the blood.

The doctor will be able to make a diagnosis during the examination. The next survey plan will look something like this:

A blood test shows an increased number of leukocytes, a decrease in erythrocytes.
Bacterial examination of the contents of the nodes helps to establish not only the cause of the infection, but also to determine the sensitivity to certain antibiotics.
A urine test will be required to exclude the penetration of infection into the urinary organs.
A biochemical blood test is necessary to determine the C-reactive protein.
In the case of the transition of the disease to the chronic stage, it is necessary to pass an immunogram to determine the cause of constant suppuration.

If hydradenitis of an intimate place is confirmed, you should immediately begin therapeutic actions.

Therapeutic measures

With the appearance of hidradenitis in the groin, treatment can be carried out by conservative and operative methods:

Antibiotics of the tetracycline, penicillin series, macrolides, fluoroquinolones are able to stop the inflammatory process: Amoxiclav, Azithromycin, Doxycycline.
If the disease is accompanied by a high rise in body temperature, non-steroidal anti-inflammatory drugs can be prescribed: Diclofenac, Naklofen.
Abscesses can be treated with ointments, creams and solutions. Bactericidal ointments are used for compresses: Clindamycin, Levosin.
Antiseptics such as Chlorophyllipt alcohol solution, Dioxidin will help to disinfect the surface.
Sometimes corticosteroids are prescribed.
If the abscess begins to mature, you can apply a gauze bandage with ointments such as: Levomekol, Ichthyol or Vishnevsky ointment. The bandage is fixed with a plaster and left overnight. In the morning after removing the bandage, treat the place with brilliant green or iodine.

Treatment can be supplemented with a course of vitamins, immunomodulators, prebiotics, and a course of physiotherapy.

If the abscess does not break through on its own, but an abscess forms, surgical intervention is performed. A deep incision is made to healthy layers of the skin, treated with antiseptics and antibiotics. Rubber drainage is installed for a day so that the remaining liquid comes out.

When one abscess appears, the operation is performed under local anesthesia. The site of inflammation is chipped with Lidocaine. In the case of repeated appearance of an abscess in the same place, a decision is made to remove the sweat gland at the site of the lesion. After removing the nodes, a bandage with Vishnevsky ointment is applied. Removal of the entire inflamed area occurs with multiple nodes under general anesthesia.

During treatment, you should follow some rules that will help achieve a speedy recovery and prevent the spread of infection:

You can't take a bath. It is allowed to wash in the shower, but first you should seal the site of inflammation with a band-aid.
Clothing should not be tight. It is better to choose underwear made from natural fabrics.
You can not shave the groin area, you can only cut the hairs.
You can not eat spicy, salty foods, you should refuse confectionery, nicotine and alcohol.
Do not use deodorants because they further clog the sweat ducts.

In the fight against hydradenitis, traditional medicine recipes can be used:

Warming up of the inflamed area with dry heat is shown. For this purpose, you can use a blue lamp or apply a heated towel to the place every hour.
You can draw out pus and reduce inflammation with onions. The onion is divided into slices, placed in the oven for 15 minutes, and then applied to the knots.
Aloe relieves swelling, prevents the spread of bacteria, disinfects the surface. It is necessary to take the fleshy leaf of the plant, wash it, remove the skin and attach it to the sore spot, fixing it with a plaster.
Curd compress helps. Mix equal amounts of cottage cheese, butter and sour cream. The bandage with the composition is left all night.
You can make lotions from decoctions of herbs such as: chamomile, succession, calendula. Herbs pour boiling water, insist. Then a gauze bandage soaked in the decoction is applied to the abscess for about 20 minutes.

Hidradenitis is dangerous with complications. Purulent processes can spread to internal organs and blood. Timely treatment will help to avoid the transition of the disease to the chronic stage and prevent relapse.

Hydradenitis or "bitch's udder" is a pathology of the sweat glands, which is caused by inflammatory processes. With proper and timely treatment, the disease can be eliminated within 5-7 days. Hidradenitis (in an uncomplicated form) does not bring much discomfort, except for an obvious cosmetic defect.

Hydradenitis is a widespread disease. For people without a medical education, this pathology is more commonly known under the popular names "bitch's udder" and "wolf's udder" because of the characteristic inflamed growths that resemble dog nipples.

Hydradenitis or "bitch's udder": how to cure at home

What it is

Hydradenitis is a pathology of the sweat glands caused by an inflammatory process. The most common causative agent of infection is Staphylococcus aureus. The disease may be chronic.

According to the place of localization, they distinguish:

in the armpits;

and hidradenitis of the scalp (in men).

Neck, face and mucous membranes are affected in rare cases.

Women who have reached puberty are most susceptible to the disease. The etiology of hydradenitis is quite simple: a bacterial infection through a wound on the skin enters the mouth of the hair follicle. At this stage, you can see a small pimple or boil, a little painful, possibly with a purulent cap. As the infection grows, pathogenic microorganisms penetrate the sweat glands and provoke an increase in foci of infection.

There are several stages of the emergence of a bough udder:

Redness and tenderness on palpation.

The appearance of red abscesses.

Spontaneous opening of abscesses, the appearance of purulent discharge.

Scarring stage.

Often, patients take only local methods of treatment - all sorts of lotions and creams, which allows you to forget about the problem for a while. But soon after a small remission and a stage of scarring, the wolf's udder appears again and all stages of the disease are repeated.

With proper treatment, pathology can be eliminated within 5-7 days.

But, oddly enough, people who have been tormented by a bitch udder for several years turn to doctors. This statistic is due to the fact that in our country the system of self-diagnosis and self-treatment is very “developed”. In the early stages, the udder can be confused with furunculosis, folliculitis and a number of other skin pathologies. Due to improper treatment, the disease begins to progress, scars appear.

Hidradenitis in an uncomplicated form does not bring much discomfort to the patient, except for an obvious cosmetic defect. But with increased inflammation, crusting, tissue damage, and sepsis can occur.

Signs of hydradenitis or how to distinguish a bough udder from other skin diseases

Hydradenitis of the armpit is localized mainly in the area of only one armpit. In some cases (complicated by concomitant chronic diseases), foci occur on two armpits and in the folds of the mammary glands.

At the stage of infection, the nodules have a red form of inflamed acne. They itch when sweating, painful on palpation. Unlike furunculosis, hydradenitis extremely rarely manifests itself on the face and in the area of the shoulder girdle. In places where there are no sweat glands and hairline, hydradenitis appears as concomitant dermatological phenomena.

The bitch udder is pea-shaped and has a blue-red hue for a long time.(with furunculosis acne with a purulent cap, small). Unlike folliculitis, hidradenitis does not affect the scalp. In the second stage, the bough udder has a pronounced rounded shape and is very painful. Several foci can merge into one.

At the stage of maturation, the patient has general weakness, pain in the focus of inflammation, fever and other signs of infection. In the third stage, the nodules begin to soften, become less painful and open.

Opened foci can fester for several days, it is possible to release serous fluid with blood fragments. Purulent thick masses have an unpleasant, pungent putrefactive odor. As soon as the discharge from the wound ends, it is delayed. In patients with a chronic form, new foci and sores appear next to the scars, which later heal.

Causes of hydradenitis

Hydradenitis is referred to as one of the forms of pyoderma.(bacterial infections that cause pustular lesions of the skin). Pathogenic microorganisms can be introduced after shaving, combing, squeezing a pimple th. Hidradenitis in the armpits in women is common, since this area of \u200b\u200bthe skin undergoes frequent destruction during epilation, and sweating increases the number of bacteria.

The occurrence and development of infection can be influenced by a number of factors, triggers for the disease can be:

high degree of sweating;

transferred dermatological diseases;

working conditions that do not meet sanitary standards;

wearing dirty underwear;

frequent use of products that mask the smell of sweat;

wearing tight synthetic underwear;

pregnancy;

microtrauma.

In people with normal immune functions, hidradenitis resolves within a week or two. x with the use of antibacterial drugs inside and local external ointments.

The complicated form is accompanied by the constant appearance of weeping sores, scarring, and an unpleasant odor. The long course of hidradenitis, which is not amenable to treatment with drugs of choice, indicates comorbidities.

Diseases in which it is difficult to get rid of the bitch udder:

type 1 and type 2 diabetes;

pathology of the endocrine system;

diseases of the cardiovascular system;

systemic violations of the outflow of lymph;

obesity.

Not a rare cause of complications may be neglect of the rules of personal hygiene or improperly selected care product for this area of \u200b\u200bthe skin.

Hydradenitis in the groin and labia develops in most cases in girls during puberty. The first symptoms of the disease are itching, redness and soreness. The lesions affect the groin area, can move to the inner thighs and labia majora. The inguinal form of the disease is painful and with a large number of complications. The process is exacerbated by the inaccessibility of lesions to fresh air and constant contact with clothing.

Unlike the axillary form, the bough udder in the groin has a wide focal localization, it can manifest itself in dozens of abscesses at the same time. This type of pathology often becomes chronic, which is difficult to get rid of. A complication of inguinal hidradenitis can be deep inflammatory processes of adjacent tissues, scarring and fistulas in the urethra, weeping ulcers, purulent arthritis, and the appearance of purulent inflammation on the rectal mucosa.

In its advanced form, the disease attracts a complex of skin inflammatory processes. in the form of scalp folliculitis, acne, skin tuberculosis, and granulomatulosis. In men, hidradenitis of the inguinal region often spreads to the area of the buttocks and anus.

Bitch udder in pregnant women

Hydradenitis during pregnancy is a common disease. There are several reasons why inflammation of the sweat glands occurs in pregnant women:

decreased immune functions;
decrease in skin elasticity;
a set of extra pounds;
hypovitaminosis;
pregnancy diabetes;
hormonal imbalance;
high sweating.

Hidradenitis during pregnancy can be localized in the armpits, in the folds of the mammary glands and groin. During pregnancy, they try to use only local preparations for treatment. The use of antibiotics and excision of abscesses by surgical methods is not indicated until the end of the second trimester.

Diagnostic procedures

Diagnosis with a bough udder includes:

external examination by a dermatologist;

visiting an infectious disease specialist;

taking a blood test for bacteriological culture;

Ultrasound of the thyroid gland;

collection of urine;

histological analysis (with complicated purulent form).

In a chronic course, the diagnosis includes a series of tests to identify the causes of weakened immunity.

This series of diagnostic procedures is aimed at excluding pathologies similar in symptomatology. Wolf udder is often confused with fungal infections, manifestations of sexually transmitted diseases, carbuncles, boils, tularemia and pathologies of the lymphatic system.

Therapy Methods

With hydradenitis, a wide range of therapeutic measures is carried out. This complex includes: antibacterial therapy depending on the causative agent of infection, local therapy (painkillers, drugs that accelerate wound healing), surgical excision of abscesses.

In the chronic form, treatment of concomitant diseases and triggers is prescribed.

The method of treatment is developed individually, depending on the stage of the disease. At an early stage, it is necessary to get rid of hair in the focal zone, but without damaging the skin. Wipe the area of infiltration with a disinfectant (calendula tincture, hydrogen peroxide, brilliant green). Do not use drugs that can cause burns(concentrated alcohol, pepper and tinctures of iodine).

After that, it is necessary to apply a bandage or plaster soaked in chlorophyllipt or dioxylin. This procedure must be repeated every 4-6 hours. If after 5 days the infiltrate does not resolve on its own, increases in size and turns into a purulent form, it is necessary to apply antibiotic therapy. Antibiotics are prescribed only when the bough's udder enters the stage of abscess formation.

With self-diagnosis and self-treatment, antibiotic therapy is often useless, due to the resistance of pathogens to the active ingredient of the drug.

For successful antibiotic therapy, the discharge is taken for bacteriological culture, to establish the exact type of bacteria and determine the most effective means to eliminate it. Taking medication lasts no more than 10 days.

The complex takes vitamins, corticosteroids and antihistamine ointments. In the chronic stage, the formation of fistulas and scars, surgical excision of foci of infection is used for effective treatment. The operation is performed under local anesthesia and lasts no more than 45 minutes, with extensive lesions.

Treatment at home

There are many "folk" recommendations on how to get rid of the bitch udder, but some of them may be contrary to common sense and aggravate the pathology. If you decide to get rid of the bitch udder without the help of a doctor, you need to know a few basic rules of therapy, and after that resort to folk recipes.

1. When an outgrowth with purulent discharge appears, in no case should warm bandages be applied.
You can not open boils and try to sanitize them yourself.

2. It is impossible to apply ointments and masks directly on open ulcers.

An effective and absolutely safe method of treating hydradenitis without drugs is sunbathing. Just clean your armpit of hair and lie down in the sun. Unfortunately, this method helps only at an early stage of the disease.

You can wipe the foci of inflammation with decoctions and tinctures of herbs with antiseptic properties (calendula, chamomile, St. John's wort, celandine).

Nutrition for hydradenitis

Diet adjustment for hydradenitis is indicated for patients with a chronic form of the disease. who have endocrine disorders.

For overweight people, calorie restriction and a low-carbohydrate diet are indicated.. In addition, they advise avoid fatty and spicy foods. Helps accelerate recovery diet rich in vitamins and fiber.

With purulent hydradenitis, you need to give up sweet and rich pastries, since such products provoke the reproduction of pathogenic bacteria and fungi. Avoid hot and spicy food which causes increased sweating.

Prevention

The basis of preventive measures is the observance of all norms and rules of personal hygiene and careful care of the groin and armpits. In order to avoid diseases, women need to use high-quality machines that do not injure the skin, and products that moisturize the skin before and after shaving. If you cut yourself while shaving, you must immediately treat the wound with an antiseptic.

An important role in the development of the disease is played by the intensity of sweating. Dermatologists recommend washing your armpits more often. Underwear should be made of natural breathable materials, loose fit. In summer, clothing should not create friction in areas of excessive sweating.published.

If you have any questions, ask them

Hydradenitis is a rather unpleasant disease and, according to statistics, is more often observed in women. The prevalence of this pathology is unknown, but it is noted that young people suffer from hidradenitis (from puberty to 45 years).

The disease never occurs in children and the elderly, which is associated with the peculiarities of the functioning of the skin (sweat glands) during these age periods. In childhood, the apocrine (sweat) glands have not yet begun to function, and in old age their function fades. People of various nationalities can suffer from the disease, but it occurs several times more often in people of the Negroid race.

The term "hydradenitis", types of disease

Hydradenitis is an inflammatory process accompanied by suppuration of the apocrine sweat glands and caused by the penetration of an infection into them, usually staphylococcal. Most often, the armpits are affected (hydradenitis under the arm), but inflammation of the apocrine glands near the navel, in the inguinal folds, around the anus, scrotum and large pudendal lips is possible.

The course of the pathology is gradual, at first the affected sweat gland increases in size (no more than a pea), thickens and becomes painful. Within a week, the inflammatory process progresses, suppurates, the gland increases to 3 centimeters in diameter and becomes pear-shaped. Outwardly, such changes very much resemble a nipple, and therefore hydradenitis is popularly called "bitch's udder".

Rare localizations of the disease include cases of inflammation of the apocrine glands of the peripapillary region and the scalp.

Classification

There are the following types of pathology:

Depending on the flow:

acute purulent hydradenitis;
chronic process.

Depending on location:

under the arm;
hydradenitis of the scrotum;
peripapillary region;
umbilical region;
perianal area;
inguinal hydradenitis and others.

Depending on the extent of coverage:

unilateral;
two way process.

Skin and skin glands: anatomy

The skin is the largest organ of the human body in terms of area and reaches two square meters in size. The skin is represented by three layers, and each performs its tasks:

Epidermis

This is the uppermost (outer layer) of the skin, its thickness is 0.1 - 1.5 mm. In turn, the epidermis includes 5 layers. In the underlying layers, cells are renewed, which replace the old cells in the upper layers of the epidermis and ensure the healing of minor skin injuries (abrasions, scratches). The upper layer is represented by keratinized and keratinized (dead) cells. The function of the upper layer of the epidermis is to mechanically protect the skin and prevent the penetration of infectious agents into the deeper layers of the skin. The entire thickness of the epidermis is penetrated by the ducts of the skin glands.

Dermis

Another name for the dermis is the skin itself, which is represented by connective tissue. The dermis has a two-layer composition:

papillary layer

Located just below the epidermis. In the outgrowths of the papillary layer are nerve endings and capillaries.

mesh layer

In addition to the blood and lymphatic vessels and nerve endings passing between the connective tissue cells, hair follicles, sebaceous, sweat glands are located in the thickness of the mesh layer. In addition, in the papillary layer there are fibers of collagen and muscle tissue, which give the skin turgor (elasticity and firmness).

Subcutaneous adipose tissue

This is the lowest layer of the skin, which is represented by accumulations of fat cells located between bundles of connective tissue. Its function is to provide additional protection of the body from damage, temperature changes and the creation of a depot of nutrients (fat reserves).

The skin has appendages, which include nails and hair, as well as glands.

skin glands

Skin glands are of two types: sebaceous and sweat. The task of the sebaceous glands is the production of sebum. Due to the fatty substance, a protective layer is formed on the surface of the skin, which prevents the penetration of liquid deep into the skin (and with water, bacteria can enter the thickness of the skin). The sebaceous glands are located superficially and the mouths open into the hair follicles. Every day, these glands produce about 20 grams of fat.

Sweat glands, as the name implies, are responsible for the secretion of sweat. Their structure is tubular, and the lower part (secreting) is represented by a tube folded into a ball and is located in the thickness of the dermis. Through the excretory ducts, sweat goes out or into the mouths of the hair follicles. Every day (average ambient temperature) is produced about 800 ml of sweat with 40 grams of salt in it.

In turn, the sweat glands are divided into:

eccrine

They are located on the entire area of the skin, but mostly on the palmar surfaces, feet and forehead. They produce transparent sweat, the composition of which is represented by water (99%) and a small amount of lactic acid, due to which the sweat gives the skin a slightly acidic reaction. The function of the eccrine sweat glands is to reduce body temperature when the body overheats due to the evaporation of fluid.

Apocrine

The localization of apocrine sweat glands is well defined. They are located in the armpits, around the nipples and navel, in the inguinal folds and near the anus. Of the total number of sweat glands, apocrine glands make up 10–30%. The sweat that these glands secrete is thicker and has a whitish tint due to fats and cholesterol. The secret of the apocrine glands has a strong, pungent odor, since the tops of the cells of these glands are destroyed and are part of the sweat.

The sweat of the apocrine glands is an excellent breeding ground for bacteria, and their reproduction and subsequent death only exacerbates the unpleasant odor. The load on the apocrine glands increases with overheating of the body or stress. In addition, these glands are activated in women during menstruation.

And if the sweat of the eccrine glands has an acidic reaction and protects the skin from the colonization of pathogenic microbes, then the sweat of the apocrine glands is either neutral or has an alkaline reaction, which is favorable for the reproduction of bacteria. This feature explains the development of hidradenitis exclusively in the apocrine sweat glands. Moreover, the ducts of the apocrine glands are much wider than the eccrine glands, which explains the easy penetration of microbes into the thickness of the glands.

Causes of hydradenitis

For the development of the disease, 3 conditions are necessary:

pathogenic microorganism (usually staphylococcus, but streptococci and E. coli are not excluded);
weakened local skin protection;
suppressed general immunity.

The causative agent of the disease

The most common cause of hidradenitis is staphylococcus aureus. Staphylococci are very common bacteria and are divided into several varieties. Some staphylococci are practically not dangerous, while others can provoke severe purulent diseases and even death:

Epidermal staphylococcus aureus

It is part of the normal microflora of the human skin and belongs to conditionally pathogenic bacteria. That is, when immunity is weakened, this form of microbes becomes pathogenic and provokes the development of pustular skin diseases.

Saprophytic staphylococcus aureus

It also colonizes human skin normally and does not pose a health hazard, except for people with suppressed immunity.

Staphylococcus aureus

The most dangerous microorganism not only among other staphylococci, but also among all bacteria in general. Thanks to Staphylococcus aureus, tonsillitis, pneumonia and sepsis occur.

About 20% of the population are healthy carriers of this infection, but they can provoke various purulent diseases in their close environment, since most people are very sensitive to Staphylococcus aureus. This type of bacteria is highly contagious and virulent (contagious).

When bacteria get on the skin, furunculosis, phlegmon, hydradenitis develop, and when they penetrate into the blood, sepsis, inflammation of the small intestine, pericarditis. A special danger to Staphylococcus aureus is added by the toxins it secretes, which destroy the cells of the body, including blood cells (erythrocytes and leukocytes).

Condition of the skin

skin pH

Normally, the skin has a slightly acidic reaction, in the range of 4 - 5.6. Such a reaction is created by sweat with weak acids containing them: lactic and others. Due to the acidic environment, a normal microbiocenosis of the skin is maintained, that is, saprophytes (safe bacteria for the skin) multiply, preventing the colonization of pathogenic microbes. But the acidity of the skin is not constant, and can change under the influence of various factors (alkaline products for skin care and hygiene, the use of baking soda inside or outside for cosmetic purposes). In this case, the skin environment becomes alkaline, which is favorable for the reproduction of pathogenic microorganisms and the development of pustular skin diseases, including hydradenitis.

sweating

Healthy skin is characterized by moderate perspiration. Sweat removes toxins and salts from the skin, thereby cleansing them. But with increased work of the apocrine sweat glands, their excretory ducts are squeezed by the "inflated" secretory part of the glands. As a result, sweat is not released, but accumulates in the glomeruli of the glands, where microbes begin to actively multiply.

Increased secretion of apocrine glands can cause: high ambient temperature (heat), fever, stress, hormonal changes.

Hormonal imbalance

The content of hormones in the body also affects the condition of the skin. For example, increased sweating and increased secretion of sebum causes an increase in testosterone, especially during puberty. In addition, blood glucose rises, which leads to a decrease in the formation of lymphocytes (immune cells). As a result, the local immunity of the skin is weakened, and, as a result, the sweat glands become inflamed.

Hormonal shifts can also be caused by polycystic ovaries, inflammation of the organs of the reproductive system, puberty, pregnancy and menopause.

Puberty

Children do not get hidradenitis because their apocrine sweat glands have not yet begun to function. But with the onset of puberty, these glands become active and begin to produce sweat in large quantities, especially in the axillary and groin areas. The reaction of the skin in these areas becomes alkaline, which predisposes to the development of hydradenitis.

allergic skin reactions

Under the influence of allergens on the skin, histamine begins to be produced, which activates immune cells. Immune cells, in turn, "attack" skin cells, causing its self-damage: increased skin temperature, swelling, hyperemia, itching. The main skin functions begin to suffer, which is only “on hand” for pathogenic bacteria, they actively penetrate into the thickness of the skin, causing a purulent inflammatory process. Allergies are provoked by cosmetics and detergents, medicines and vitamins, some foods (nuts, chocolate, citrus fruits).

diaper rash

Diaper rash is formed in the skin folds, where there is increased sweating, air does not enter and sweat does not evaporate. As a result, the skin is constantly moist and softened. When rubbing the skin in the folds, microtraumas occur, where microbes (fungi, viruses and bacteria) quickly settle. As a rule, diaper rash is characteristic of obese people (armpits, intergluteal and inguinal folds, under the mammary glands).

The following factors provoke the occurrence of hydradenitis:

neglect of the rules of personal hygiene;
hair removal and shaving (microtrauma);
frequent washing (more than once a day);
wearing synthetic or tight underwear (micro abrasions);
use of antiperspirants (blockage of sweat glands);
endocrine diseases (diabetes mellitus, pathology of the thyroid gland, adrenal glands and pituitary gland);
obesity;
violations of embryogenesis, when the wrong ducts of the apocrine glands are formed.

Immunity

Immune suppression occurs as a result of:

Depletion of the body:

high physical activity;
acute infectious diseases, poisoning;
sleep disturbance (chronic insomnia);
trauma/surgery;
massive blood loss or small but constant blood loss;
nervous tension/stress.

Chronic diseases:

tuberculosis;
herpetic infection;
viral hepatitis;
HIV infection;
toxoplasmosis;
helminthic invasion.

Taking medication:

cytostatics;
antibiotics;
glucocorticoids (prednisolone, dexamethasone).

Congenital immune pathology:

hereditary neutropenia;
X-linked agammaglobulinemia;
combined immunodeficiency.

Autoimmune diseases:

rheumatic lesions;
lupus erythematosus;
scleroderma.

Irrational nutrition:

mono-diets;
vegetarianism;
vitamin deficiency.

Age periods:

childhood;
old age;
pregnancy;
menopause.

Development mechanism

The duct of the sweat gland is clogged with a cork from the scales of the desquamated epithelium and the secretion of the gland. As a result, both the duct and the gland increase in size, as sweat has accumulated in them. Microorganisms begin to multiply in the gland, which leads to the development of inflammation. Then the gland ruptures and the infection spreads to surrounding tissues. The focus of inflammation is delimited by a connective tissue capsule, pus accumulates in it. After the opening of the purulent cavity, the outpouring of pus occurs, which leads to the deposition of fibrin on the walls of the cavity and the formation of fistulous passages.

Clinical picture

In its development, hydradenitis goes through several stages:

Infiltration stage

As a rule, the disease develops on the one hand, but bilateral lesions are also possible, for example, bilateral axillary hidradenitis. At the stage of infiltration, small dense nodules appear separately located from each other in the skin. Their appearance is accompanied by itching and slight soreness, which increases with pressure on the nodule. The size of the nodules varies from 2 - 3 millimeters to 1.5 - 2 cm. Reddening of the skin is noted at the site of the lesion.

ripening stage

As the disease progresses, the nodules begin to rapidly enlarge and coalesce. They protrude above the skin and look like nipples. The color of the skin at this stage becomes purple-cyanotic, there is severe pain not only during movement, but also at rest. The fusion of the nodules leads to the formation of a diffuse infiltrate, which has a dense texture and disc shape, therefore it is similar to the phlegmon clinic. The maturation stage is accompanied by a pronounced intoxication-inflammatory syndrome.

Stage of spontaneous opening

As the focus of inflammation matures, its central part gradually softens and hydradenitis opens. In the process of opening, pus is released in a significant amount, which looks like thick sour cream. The purulent discharge may contain blood impurities. To differentiate the disease, especially hydradenitis in the groin, follows from the boil. With suppuration of the hair follicle (furuncle), there is always a necrotic rod (hair). Spontaneously, hydradenitis opens approximately 7 to 10 days after the onset of development. As soon as the purulent focus has opened, the general condition of the patient improves, and the pain is significantly reduced.

Healing stage

After opening the abscess, a bleeding and festering ulcer forms at this place, which gradually heals. After healing, a retracted and rough scar is formed on the skin. The whole process from the onset of the pathology to the formation of a scar is about 14-16 days. The danger of hidradenitis is that, along with a cicatrizing ulcer, adjacent apocrine glands can inflame and suppurate in parallel (the process of inflammation does not bypass them either). In this case, they speak of a protracted or chronic relapsing course, which is accompanied by exacerbations of 10 or more times.

Interpretation of the symptoms of hydradenitis

It occurs due to circulatory disorders in the affected area, where fluid stagnation has appeared.

Swelling tissues pinch the nerve endings, which causes pain. The more swelling increases, the more intense the pain.

Color of the skin

Stagnation of blood leads to the accumulation of red blood cells in the capillaries, which first gives a reddish tint to the skin, and then, as the red blood cells are destroyed, the color changes to a bluish-purple.

Infiltrate

Around the purulent focus, white blood cells are concentrated - leukocytes, which are designed to fight pathogens. A massive accumulation of leukocytes leads to the formation of a dense and flat infiltrate. Leukocytes and lymph are not only in the skin, but also thicker than the subcutaneous fat, and the infiltrate can spread to the entire surface of the armpit.

Intoxication syndrome

High fever, fever followed by chills, lack or loss of appetite, nausea and vomiting, general weakness - all these signs are caused by toxins that Staphylococcus aureus produces.

Purulent cavity

Pathogenic microbes lead to tissue necrosis of the apocrine gland, the secreting part of it breaks and a cavity is formed in which pus is located (dead cells and bacteria, sweat processed by microbes).

Autopsy of hidradenitis

As pus accumulates in the focus of inflammation, pressure increases, which one of the walls of the cavity cannot withstand and an autopsy occurs with the outpouring of a large amount of creamy pus.

Treatment of hidradenitis

How to treat hydradenitis? The answer depends on the stage of inflammation and its severity. Therapy of the disease should be complex, and in the stage of maturation of the abscess, surgical intervention is performed.

Antibiotic therapy

With hydradenitis, antibiotics are mandatory. The selection of antibacterial drugs is carried out by the doctor, focusing on the results of the tests obtained and the type of isolated pathogenic microorganisms. Depending on the severity of the course of the disease, antibiotics are prescribed orally (by mouth) or intramuscularly. On average, the duration of the course of antibiotic therapy is 7-10 days, but it is possible to lengthen it or replace drugs if there is no effect from the treatment. Broad-spectrum antibiotics are used that are most effective against Staphylococcus aureus and Streptococcus aureus:

tetracyclines (doxycycline);
macrolide group (azithromycin or erythromycin);
a group of cephalosporins (kefzol, ceftriaxone);
fluoroquinolones (ciprolet);
penicillin group (amoxiclav).

Diet

Treatment of hidradenitis includes diet. Patients are recommended a complete and vitamin-enriched diet, the principles of which must be followed not only in the process of development and cure of the pathology, but also for another three months after recovery. It is strictly forbidden to use spicy dishes and seasonings, alcohol, pastries, smoked meats, sausages and confectionery (sweets, creams, mousses, marshmallows, chocolate) and indigestible fats (animals): lard and butter. The diet should be dominated by fresh fruits and vegetables, food should be steamed, boiled or baked. Also, the diet should contain fermented milk products to restore normal intestinal microflora, and replace animal fats with vegetable oils. Replace fatty meats and fish with lean ones, and include nuts and cereals (cereals) in the diet as a source of vitamin E (an antioxidant, accelerates healing) and fiber.

Treatment in the stage of infiltration

Treatment of hidradenitis in the stage of infiltration (the first three days) is carried out at home and involves, in addition to taking antibiotics, local therapy. Local treatment consists in treating the skin with alcohol solutions of antiseptics (iodine, brilliant green, camphor or salicylic alcohol, boric acid, chlorhexidine).

After each treatment of the focus of inflammation, wet-drying semi-alcoholic dressings are applied (dioxidine diluted with water and alcohol, alcoholic tincture of calendula with the addition of water, alcoholic solution of chlorphyllipt with the addition of water). As soon as the bandage has dried, it is moistened again with the prepared solution and the manipulation is repeated twice a day for 3 hours. From above, the bandage is not closed with anything to prevent the greenhouse effect.

It is strictly forbidden:

taking baths, visiting saunas and baths (hot air, high humidity and water aggravate the spread of infection):
shaving / hair removal in the lesion (additional injury to the skin and the spread of inflammation);
wearing tight clothing made of synthetic materials;
the use of compresses and dressings with ointments (cause weeping of the skin, increase infiltration and spread the infection).

wearing loose-fitting clothes made from natural fabrics;
daily shower, pre-close the lesion with a band-aid;
individual towel and bed linen, daily change;
treatment of the focus of inflammation after a shower with a solution of potassium permanganate;
drying of skin folds with powders (talc, zinc oxide);
dry heat to the site of inflammation (ironed towel, irradiation with a blue lamp for 5 minutes, sunbathing for 10-20 minutes, depending on the time of day and season).

Surgery

Surgical intervention is carried out when the disease passes into the stage of maturation, when it was not possible to stop the development of hidradenitis in a conservative way. To begin with, the “ripening” of the abscess is activated. For this purpose, ichthyol cakes about 3 mm thick are applied to the affected area, covering the medicine with a thick layer of cotton wool from above.

Thus, in the focus of inflammation, the temperature rises and the abscess "ripens", ready to break through. The lozenges should be applied twice a day. After suppuration of hidradenitis, the doctor dissects it with a wide and deep incision to the level of healthy tissues. The wound is washed with an antiseptic solution, then with an antibiotic and drained. The management of the postoperative wound is carried out in an open way, that is, no stitches are applied.

With a recurrent process, after opening the abscess and its healing, the second stage of the operation is performed. At this stage, the doctor excised the affected glands along with subcutaneous fat and skin. The resulting skin defect is produced with the patient's own skin flaps, for example, from the back.

Physiotherapy

In addition to antibiotics and surgery, physiotherapeutic procedures are actively used in the treatment of pathology.

In the infiltration stage are assigned:

SMT-phoresis;
UV therapy in the focus of inflammation.

After surgical treatment, to accelerate the regeneration processes, the following are used:

infrared irradiation;
laser therapy;
magnetotherapy;
ultrasound;
electrophoresis with drugs (unithiol, dionin).

Question answer

Which doctor treats hydradenitis?

If the process has not yet reached the stage of suppuration, that is, it is in the process of infiltration, the treatment is carried out by a dermatologist. With suppuration and the threat of opening the abscess, the surgeon is involved in the treatment.

Why is hydradenitis dangerous?

The disease, in the absence of timely and adequate treatment, threatens to turn into an abscess or phlegmon. In advanced cases, infectious agents penetrate into the general bloodstream, which is fraught with blood poisoning - sepsis.

Is it possible to use alternative methods of treatment for hydradenitis and which ones?

If you try to get rid of the disease only with the help of traditional medicine, then at best the abscess will “ripen” and open on its own, and at worst there will be severe purulent-septic complications. Alternative methods of treatment are allowed to be used for this pathology, but as an addition to the main treatment and the permission of the doctor. You can apply beaten leaves of plantain and celery, cut aloe leaves to the site of inflammation - all these plants have bactericidal properties. It is also allowed to treat the affected area with decoctions and infusions of herbs with antiseptic properties (chamomile, calendula, linden, sage, yarrow.

Is it necessary to go to the hospital with hydradenitis?

No, not necessarily. Only patients with a recurrent and chronic process requiring radical surgery are hospitalized, with a severe course of the disease and a severe general condition of the patient.

Is hydradenitis related to hereditary diseases?

There are no exact data on this issue, but it can be said that increased sweating (hyperhidrosis), obesity and other factors that predispose to the occurrence of hydradenitis are inherited.

Hydradenitis in an intimate place. How to treat the disease "bitch udder", what to do at home

Stages of hydradenitis: stage of infiltration; stage of suppuration; an abscess has formed and may rupture.

Classification of hydradenitis: purulent hydradenitis; axillary hydradenitis; inguinal hydradenitis; chronic hydradenitis; suppurative hydradenitis.

Causes of hydradenitis

Purulent hydradenitis - causes

Hydradenitis - the initial stage

Recurrent hydradenitis

Suppurative hydradenitis

Hydradenitis in the groin

Hydradenitis under the arm

Which doctor should I contact with hydradenitis?

Symptoms

The clinical picture of hydradenitis

Symptoms of complications of hidradenitis

Diagnostics

Laboratory and instrumental research methods for hydradenitis

Treatment

How to get rid of hydradenitis at the initial stage?

How to treat hidradenitis - personal hygiene and skin care

Purulent hidradenitis - treatment

Hidradenitis - surgical treatment

Physiotherapy for hydradenitis

Prevention of hidradenitis

Medications

Vishnevsky ointment

Ichthyol ointment

Levomekol

Erythromycin

Dimexide

Amoxicillin

Folk remedies

Aloe disinfection

Treatment with onions

Honey and propolis

Sour cream and rye flour

Herbal remedies

To heal a burst abscess

What is hydradenitis

ICD code 10

The structure of the skin and sweat glands

Hydradenitis formed in the inguinal zone

Hydradenitis in the groin in women

Hydradenitis during pregnancy

The main causes of the disease

Population by staphylococci

properties of the skin

The state of the immune system

Where is hydradenitis most often formed?

The main symptoms of inflammation

Which doctor to contact

Diagnostics

Treatment Method

Immunity Boost

Keeping a sleep and physical activity schedule

Treatment during the first 3 days

Disinfection of the skin around the inflammation

Observance of certain hygiene

Appointment of compresses, warming up and physiotherapy procedures

Treatment after 3 days and the possibility of surgery

Prevention

Cost of treatment

The manifestation of the disease

Therapeutic measures

Hydradenitis or "bitch's udder": how to cure at home

What it is

Signs of hydradenitis or how to distinguish a bough udder from other skin diseases

Causes of hydradenitis

Bitch udder in pregnant women

Diagnostic procedures

Therapy Methods

Treatment at home

Nutrition for hydradenitis

Prevention

The term "hydradenitis", types of disease

Classification

Depending on the flow:

Depending on location:

Depending on the extent of coverage:

Skin and skin glands: anatomy

Epidermis

Stages of hydradenitis:
stage of infiltration;

stage of suppuration;

an abscess has formed and may rupture.

Classification of hydradenitis:
purulent hydradenitis;

axillary hydradenitis;

inguinal hydradenitis;

chronic hydradenitis;

suppurative hydradenitis.