Hidradenitis under the armpit and other localizations. Causes, symptoms, treatment

Causes, symptoms and treatment of purulent hidradenitis

Soft tissue infections are the most frequent reason for referral to a polyclinic surgeon (more than 70%). One of the diseases of this group is acute purulent hidradenitis, or inflammation of the sweat gland. Most often, hidradenitis occurs under the armpit, less often - in the groin area and in other places where there are skin folds. Read about this pathology on our website Dobrobut.com.

Causes of hidradenitis (axillary, inguinal, other localizations)

The main factor is personal unkemptness. If a person ignores the rules of personal hygiene, does not take a shower or bath in a timely manner, the skin becomes a favorable environment for the rapid growth of microorganisms, including staphylococcus aureus. Recently, the main cause of suppuration of sweat glands in the armpit and inguinal region is shaving. Micro-cuts that occur in the process of shaving become an entrance gate for infection.

In addition to sloppiness, obesity plays a big role, because of which the folds of the skin do not dry in a timely manner (microbes multiply ten times more actively in a humid environment). Exposure also reduces the protective functions of the skin. Finally, diabetes impairs the nutritional function of blood vessels, which is also a favorable background for the development of purulent skin infections.

The use of antiperspirants is based on blocking the function of sweat glands. Because of this, sweat does not wash their ducts, staphylococci aureus does not wash out, and inflammation develops in the sweat gland itself.

Where does hidradenitis occur

Typical localization is the axillary region (the same in women and men), hidradenitis in the groin (more often in women due to shaving of the intimate area), in the area of ​​the areola of the nipple and under the mammary glands. Genital hidradenitis occurs less often (in men - scrotum, in women - labia majora), as well as on the face (mainly in men).

Such localizations are associated with the fact that the apocrine sweat glands located in these places are most often prone to inflammation. Their feature is the tortuousness of the ducts, which impairs the outflow of sweat and contributes to inflammation when Staphylococcus aureus penetrates the gland.

Stages of hidradenitis disease

There are no clear stages of disease development. It all starts with the appearance of a painful small nodule under the skin in a typical place. At first it is not visible, but you can feel it. After 24-48 hours, it significantly increases in size, the skin above it turns red, and then turns blue. The pain becomes very strong, often prevents active movements of the limb.

At this moment, there is a process of tissue melting in the thickness of the node, which is manifested by the appearance of fluctuations (when palpating the node, it is felt that its center seems to collapse under the finger). The skin over the abscess gradually thins until a small hole appears in it, through which thick pus begins to flow. This usually happens on the 7-10th day after the onset of the disease. Often, in the absence of treatment of purulent hidradenitis, the process ends with the formation of a fistula, through which serous-purulent contents constantly flow.

The subcutaneous tissue is penetrated by a large number of lymphatic vessels. Therefore, the infection can spread to nearby sweat glands. The general condition of the patient may also suffer. Symptoms of chronic hidradenitis: the body temperature rises, there is a feeling of exhaustion, weakness, sleep and work capacity are disturbed. Due to the massive damage caused by the infection, the subcutaneous tissue swells greatly, the foci of infection protrude above the skin, forming a picture similar to a "bitch's udder" (this became the popular name of the disease).

Treatment of hidradenitis

In the stage of formation of an infiltrate, it is possible to treat hidradenitis of the inguinal region, armpits and other localizations conservatively. In the first or second day, it is recommended to use local remedies. Antibiotics for hidradenitis are used in the form of an ointment. Most often, it is tetracycline, erythromycin ointment or lotions with clindamycin. Acute purulent hidradenitis cannot be cured by conservative methods most of the time and it is necessary to resort to surgical intervention.

Adequate drainage is a key point in the treatment of any purulent process. Hidradenitis dissection operation is the best way. According to surgeons, the most appropriate method of pain relief is anesthesia. This allows you to avoid the appearance of side effects from anesthetics, which would have to be administered in too large a quantity.

Operation progress:

1. The skin above and around the abscess is treated with antiseptics.
2. A small incision is made to the entire depth of the skin until the abscess cavity is opened.
3. The cavity is treated with antiseptics, then drained with gauze turunda with water-soluble antibiotic ointment.
4. In case of multiple lesions of the sweat glands, each abscess opens separately. If the foci are located very close to each other, it is better to remove the entire inflammatory conglomerate within healthy tissues. In this case, the wound is sutured. In all others, it heals on its own.

After the operation, daily bandages are performed, during which the skin around the wound is treated with antiseptics. They wash the cavity of the abscess, change turundas with ointment. At the end of the dressing, bandages with antimicrobial ointment are applied to the wound.

Turunda is removed after pus stops coming out of the wound. After that, it quickly heals on its own. Dressings continue until the wound is completely healed.

General conservative treatment is usually carried out after surgery, when hidradenitis recurs or many sweat glands are affected. Then apply:

• courses of antibiotic therapy with cephalosporins and semi-synthetic penicillins;
• transfusion of antistaphylococcal plasma;
• UV irradiation of blood;
• laser irradiation of blood;
• vitamin therapy.

In case of pain syndrome, non-narcotic analgesics are prescribed, in case of sleep disturbances, appropriate hypnotics are prescribed.

How to prevent hidradenitis

Measures to prevent hidradenitis are simple:

• compliance with the rules of personal hygiene;
• rejection of antiperspirants (use lotions with solutions or powders);
• rejection of synthetic underwear;
• daily change of underwear, especially in summer;
• weight loss;
• thorough treatment of chronic foci of infection of any localization (their presence reduces the body's defenses);
• rejection of frequent shaving (it is better to do laser hair removal).

Prophylaxis of hidradenitis is also necessary during pregnancy. Hidradenitis is an unpleasant, but not fatal disease. A timely visit to the doctor will avoid long-term disability and the development of complications.

Related services:
Surgical operations
Therapeutic hospital