Laser Hair Removal with Hidradenitis Suppurativa: June 2nd

Tuesday, June 17, 2008

June 2nd – June 15th, 2008

Skin in the Laser Hair Removal site is doing good. There have been no HS lesions. However the hair has already started to grow back.

On June 15th, I took the scary plunge and picked up my razor and shaved all my hair off in the area, which was needed for the procedure. I'm hoping that there won't be any negative reprecussions of this, but there probably will be flare ups.

What Hidradenitis Suppurativa Is

HS is a disabling, painful, deforming, chronic, incurable skin disease that occurs in the inverse areas of the skin, e.g. groin, armpits, breast, and buttocks. It is still considered a rare disease despite the estimates that one to twelve million people in the US alone suffer from this debilitating disease. Hidradenitis Suppurativa is often misdiagnosed by medical professionals and its sufferers are often hesitant to seek medical advice because it can appear in very personal places. This is compounded by the fact that when they do seek medical attention they are often accused of having poor hygiene by medical professionals uneducated in this disease or are given useless and sometimes harmful medication.

Secondary Bacteria in Hidradenitis Suppurativa

The disease is therefore related to other follicular diseases, such as acne or pilonidal cyst, although they are not identical. [1]

This painful, disfiguring, and at times debilitating disease is marked by periods of inflammation with occasional secondary infection… [2]

Although HS lesions are most often found to be sterile, susceptible bacteria are occasionally found to aggravate the condition [1,3]

We believe with many others that bacterial involvement is not a primary pathogenic event in acne inversa, but that it is secondary to the disease process. In most studies of acne inversa, samples for bacteriological culture have been collected from the surface of the lesions. With this technique, however, contamination from resident skin bacteria obscured the interpretation of the culture result. Recently, Jemec et al circumvented the problem by introducing a method for bacteriological sampling from the deeper parts of acne inversa by an aspiration technique. The cultures were negative in half of the cases. [3,4]

Cultures of active lesions and serological analysis of circulating IgG antibodies were studied in 41 patients. RESULTS: Bacteria were found in 49% (20/41) of all lesions [3]

Bacterial involvement of acne inversa is not a primary pathogenic event, but is secondary to the disease process. [5]

The boils have pus, but no bacteria [6]
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[1] Medical Treatment of Hidradenitis Suppurativa. Jemec GB. , Expert Opin Pharmacother. 2004;5(8):1767-1770.

[2] Hidradenitis Suppurativa: A Treatment ChallengeNIPA SHAH, M.D., University of Illinois College of Medicine, Chicago, Illinois Am Fam Physician 2005;72:1547-52, 1554. American Academy of Family Physicians.

[3] The bacteriology of hidradenitis suppurativa. Jemec GB, Faber M, Gutschik E, Wendelboe P Dermatology. 1996;193(3):203-6.

[4] Acne inversa (alias hidradenitis suppurativa)T Jansen, * P Altmeyer, G PlewigàJEADV (2001) 15, 532–540

[5] What’s new in acne inversa (alias hidradenitis Suppurativa)Thomas Jasen, Gerd Plewig JEADV (2000) 14, 342-343

[6] Dr. A. Rockoff, a board certified dermatologistAffiliated with Tufts University School of Medicine.

Hormones in Hidradenitis Suppurativa

The disease almost always occurs after puberty and before age 40, leading to the theory that there is a hormonal component to the pathogenesis. [7]

Flare-ups have been linked with menses [8]

Other medical treatment options address the possible hormonal etiology of hidradenitis; these options include oral contraceptive agents that contain a high estrogen-to-progesterone ratio and low androgenicity of progesterone.[9]

Approximately 50% of female patients report a disease flare before or during menstruation. [10]
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[7] Hidradenitis Suppurativa: A Treatment Challenge - Nipa Shah, M.D., University of Illinois College of Medicine

[8] The natural history of hidradenitis suppurativa. - Von der Werth JM, Williams HC,J Eur Acad Dermatol Venereol 2000;14:389-92

[9] Behrman RE, Kliegman R, Jenson HB, eds. Nelson Textbook of pediatrics. 16th ed. Philadelphia: WB Saunders, 2000.

[10] Hidradenitis suppurativa Jan von der Werth MRCP Consultant DermatologistDermatology in Practice, Volume 9, Number 3, 2001 ISN: 0262-5504

Laser Hair Removal with Hidradenitis Suppurativa

Tuesday, June 17, 2008

June 2nd – June 15th, 2008

Some Pictures of my HS

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Info and Videos

What Hidradenitis Suppurativa Is

What Hidradenitis Suppurativa Is NOT

Secondary Bacteria in Hidradenitis Suppurativa

Hormones in Hidradenitis Suppurativa

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