Boils and Abscesses

Treatment of hidradenitis suppurativa

This is an inflammatory condition consisting of polyporous, multiheaded comedones or pseudocomedones, nodules and abscesses. The condition often affects the armpits, breasts, groin and buttock areas. Associated conditions include spondyloarthritis, obesity, diabetes, raised lipids and increased incidence of smoking. Smoking is known to stimulate the inflammatory response.

Complications that can occur are chronic lymphoedema, squamous cell cancer on the buttock particularly in men, anaemia of chronic disease, low protein, inflammatory bowel disease and SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis).

Treatments of hidradenitis suppurativa

Mild cases may be well controlled with topical antibiotics. More severe cases require oral treatments. Until recently more severe cases responded poorly to oral treatment until the arrival of a newer drug, a biologic. The latter was recently approved in mid-2017 for Medicare subsidy for severe hidradenitis suppurativa in patients over the age of 18. Younger patients with hidradenitis suppurativa may be able to access the medication off-label but will require TGA approval.