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hidradenitis suppurativa : ウィキペディア英語版
hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a common (though rarely diagnosed), chronic skin disease characterized by clusters of abscesses or subcutaneous boil-like "infections" (oftentimes free of actual bacteria) that most commonly affects apocrine sweat gland bearing areas, such as the underarms, under the breasts, inner thighs, groin and buttocks. The disease is not contagious. There are indications that it is hereditary among certain ethnic groups and autoimmune in nature. Onset is most common in the late teens and early 20's.
HS outbreaks are painful in tender areas and may persist for years with interspersed periods of inflammation, often culminating in sudden drainage of pus. This process often forms open wounds that will not heal and frequently leads to significant scarring. For unknown reasons, people with HS develop plugging of their apocrine glands. Incision and drainage procedures may provide symptomatic relief.
HS flares may be triggered by emotional/erotic stress, sweating, hormonal changes, heat and humidity, and the condition is exacerbated by friction from clothing.
Persistent lesions may lead to the formation of sinus tracts, or tunnels connecting the abscesses or infections under the skin.〔(【引用サイトリンク】title=Mayo Clinic site )〕 At this stage, complete healing is usually not possible, and progression is variable, with some experiencing remission for months to years at a time, while others may worsen and require multiple surgeries. Bacterial infections and cellulitis (deep tissue inflammation) are other common complications of HS. Depression and physical pain are often seen with HS and can be difficult to manage.〔(【引用サイトリンク】title=HS-USA :: What is Hidradenitis Suppurativa? )
HS often goes undiagnosed for years due to embarrassment causing delay in seeking treatment. Due to the "invisible" nature of it, it is frequently misdiagnosed.〔 There is currently no known cure nor any consistently effective treatment.
Carbon dioxide laser surgery has been shown as an effective treatment providing quality of life improvement, with peer reviewed articles showing an 80% chance of non recurrence in the surgically removed site.
Lukewarm Sitz baths can provide great relief, gentle antiseptic skin cleansers and hydrogen peroxide assist in keeping affected areas free of bacteria.
HS is an orphan disease due to lack of publicity and sparse research efforts. The incidence of HS is not well established, but has been estimated as being between 1:24 (4.1%) and 1:600 (0.2%).〔(【引用サイトリンク】title=HS-USA: Prevalence of Hidradenitis Suppurativa )
==Causes==
The cause of HS remains unknown and experts disagree over proposed causes.
Lesions occur in any body areas with hair follicle although intertriginous areas such as the axilla, groin, and perianal region are more commonly involved. This theory includes most of the following potentials indicators:〔Schawartz's principles of surgery, 8th edition, self assessment an board review, chapter 15, the skin and subcutaneous tissue, question 16〕
* Post-pubescent individuals are more likely to exhibit HS.
* Plugged apocrine (sweat) gland or hair follicle
* Excessive sweating
* Sometimes linked with other autoimmune conditions
* Androgen dysfunction
* Genetic disorders that alter cell structure
* Patients with more advanced cases may find exercise intolerably painful, which may increase the rate of obesity among sufferers.
The historical understanding of the disease suggests dysfunctional apocrine glands〔 or dysfunctional hair follicles,〔(【引用サイトリンク】title=HSF – What is Hidradenitis Suppurativa? What is HS? )〕 possibly triggered by a blocked gland, create inflammation, pain, and a swollen lesion.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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