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What does the history of hidradenitis suppurativa tell us from 1833 to the present?
HS can significantly limit many daily activities, such as walking, hugging, moving, and sitting. In patients with lesions in the sacral, buttocks, perineum, thighs, inguinal, or genital areas, disability in sitting may occur; prolonged sitting may also aggravate the skin condition in these patients. Although the specific cause is usually unknown, it is believed to involve a combination of genetic and environmental factors.
HS affects approximately 1-4% of the population, with women three times more likely to be diagnosed than men.
The disease usually begins in young adults and may become less common after age 50. The condition was first described by French anatomist Alfred Velpeau between 1833 and 1839.
Causes and predisposing factors
The exact cause of hidradenitis suppurativa is not known, but experts believe it may stem from a combination of genetic and environmental factors. An immune-mediated pathology may be involved, although environmental factors have not been ruled out. Lesions typically appear on any area of the body that has hair follicles and sweat glands, but are most common in the axilla, groin, and perineum.
Triggers include obesity, tight clothing, hot and humid climates, and stress.
Obesity is considered an exacerbating factor rather than a direct causative factor. Experts are also studying the effects of certain medications, such as oral contraceptives and cigarettes, and are divided over the link to certain body hair removal products.
Diagnosis and its impact
Early diagnosis is crucial to avoid tissue damage, but HS is often misdiagnosed or diagnosed late because medical professionals are unaware of the condition or patients fail to consult a doctor. On average, the global delay in diagnosis is more than seven years, which is much longer than for other skin diseases.
Many patients suffer physical and psychological pain, isolation and social difficulties due to HS.
Treatment methods
Treatment depends on the presentation and severity of the disease. Because the disease has not been adequately studied and the effectiveness of drugs and therapies is unclear, current treatment options include antibiotics, immunosuppressants, laser therapy, and surgery. These choices are made based on the patient's specific circumstances: /p>
- Antibiotics are used for their anti-inflammatory properties rather than for the infection.
- Surgery may be the best option in chronic processes and generally requires a liberal resection.
- Recently, the European Commission approved Cosentyx (secukinumab) for the treatment of moderately to severely active HS.
Future Outlook
People with HS are at increased risk for diabetes, autoimmune diseases, and certain cancers. Studies have shown that management of these comorbidities may help alleviate HS.
Our understanding of HS continues to grow, and as new treatments are developed, the quality of life for patients with HS will hopefully improve. As a rare and challenging disease, HS requires patients to cope not only with physical symptoms but also with psychological and emotional burdens.
In the future, as we continue to explore and understand hidradenitis suppurativa, to what extent can patients' quality of life be improved?
