People with hidradenitis suppurativa are commonly misdiagnosed with other illnesses such as folliculitis and acne. A dermatologist can provide a precise diagnosis.
Hidradenitis suppurativa (HS) is a skin disorder that causes inflammation. It causes painful lumps under the skin to form.
It is unknown exactly what causes HS. When hair follicles get clogged and irritated as a result of keratin, perspiration, and germs, the condition occurs. These lumps can break open, causing infection, and they frequently leave scar tissue when they recover.
In its early stages, HS appears as little red lumps on the skin. Bacterial accumulation can cause follicles to grow and fuse together as the disease advances. This can result in the formation of tunnels beneath the skin, which can transmit infection and become quite painful.
HS is frequently misdiagnosed, particularly in its early stages. As a result, adequate therapy is delayed. The average time between the beginning of symptoms and diagnosis for those with HS is ten years. Many patients are diagnosed with HS at a more severe stage due to the delay in diagnosis.
One reason for the delay in receiving a thorough diagnosis is that HS might resemble other skin problems. Making an appointment with a dermatologist, who specializes in the diagnosis and treatment of skin problems, can help you identify whether you have HS or something else.
Meanwhile, here are other conditions that may resemble HS.
Acne
Acne vulgaris, also known simply as acne, is a common skin disorder. Acne can be characterized by pimples, blackheads, whiteheads, and cysts.
Some people have skin that produces more sebum, the natural oil of the skin. As a result, they may be more prone to acne. Acne develops when pores become clogged with dead skin cells and sebum. When pores become clogged, they become irritated, which leads to acne.
Early stages of HS can resemble acne. Small red lumps on the skin’s surface can be caused by either condition. However, the location of the red bumps in HS and acne is frequently different.
Acne appears most frequently on the face, back, chest, and shoulders. HS is more prone to occur where skin scrapes against skin. HS is most commonly found in the buttocks, breasts, underarms, and around the genitals.
HS is often more painful than acne. Acne can cause pain and edema, although not as much as HS. Some acne spots may burst as a result of poking and prodding, although they rarely do so on their own. HS pimples get inflamed and frequently explode on their own.
Acne vulgaris
Acne conglobata is an uncommon and severe form of acne. Acne conglobata, like the more prevalent kind of acne, causes pores to clog with dead skin cells and oil and become irritated.
Inflamed pores develop beneath the skin’s surface in acne conglobata. Inflammation and infection spread as the irritated pores merge together. In HS, this is analogous to how infection spreads.
Acne conglobata and HS have a similar appearance. Scarring can be severe in both circumstances. This explains why acne conglobata is one of the most common HS misdiagnoses.
Acne conglobata is frequently identified based on a patient’s medical history. It is more likely to occur in those who use anabolic steroids, take thyroid medicine, have androgen-producing tumors, or have been exposed to halogenated aromatic hydrocarbons.
Both HS and acne conglobata can affect the same areas, although there are notable variances. Acne conglobata is most commonly found on the face, chest, shoulders, thighs, and upper arms. Both acne conglobata and HS can appear on the buttocks, but HS is more likely to appear where skin rubs against skin.
Cysts
A cyst is a skin bulge that contains yellow or white fluid and debris. It usually appears on the face, back, trunk, or scalp, but it can also arise in other places.
Cysts can be caused by a variety of factors. They can be caused by HS, although they can also occur for other reasons.
Cysts are common after an injury or surgery. It is sometimes caused by acne. In some circumstances, cysts appear for no apparent reason.
Although cysts are not hazardous, they might cause discomfort or suffering. Cysts can rupture and then regrow, usually in the same location, though they don’t always do so. If the cyst is associated with HS, it is more likely to spread after it ruptures.
The typical cyst grows slowly. HS has a rapid growth and dissemination.
Ingrown Hair
Ingrown hairs occur when a hair curls back into the follicle rather than growing out. Ingrown hairs can cause redness and itching of the follicles. Sometimes there is some pus or hair stuck inside.
Ingrown hairs are most common following hair removal, such as waxing or shaving. They are also more common if you have thick or curly hair. After hair removal, you may experience several ingrown hairs in the same region as the hair grows back.
Ingrown hairs normally do not require treatment and resolve on their own. HS lumps often expand and spread.
Folliculitis
Folliculitis is caused by an infected or inflamed hair follicle, which results in a lump or pustule. This can happen when the hair follicle is injured, which can happen as a result of:
wearing restrictive garments
shaving and waxing while in a hot tub
Hair follicle damage renders it more susceptible to infection.
Small, red, inflammatory patches characterize the early stages of folliculitis. It could be irritating or uncomfortable, or you could not feel anything at all. Early HS is more likely to manifest as a lump beneath the skin or as little, sensitive pimples.
Folliculitis can occur anyplace there are hair follicles, which is the majority of your body. It usually goes away on its own after a few weeks. If not, the infection will grow and the red pimples will become larger and packed with pus.
Meanwhile, HS does not usually go away on its own without treatment.
Boils
Boils are pus-filled skin infections that develop near a hair follicle or an oil gland. They are usually red or purple and bloated.
A boil develops when germs such as Staphylococcus aureus invade a cluster of hair follicles and the skin around them. A bite or injury to the skin can increase your chances of developing a boil in that area.
Boils can be caused by HS, but not all boils are caused by HS.
Boils are more common on the neck, cheeks, buttocks, and thighs. Several of these locations are also popular for HS.
Boils can sometimes expand until they burst, causing infection to spread. Multiple boils can grow and enlarge till they connect with HS as the illness advances. This can result in the formation of tunnels beneath the skin, which can transmit the illness. Boils that are not associated with HS are less likely to spread in the same manner.
Sometimes a boil will go away on its own. Sometimes it returns and requires therapy to prevent it from recurring.
Summary
Hidradenitis suppurativa is a common misdiagnosed skin disorder. This can be tedious and time-consuming. It also implies that many people have advanced HS by the time they are diagnosed.
If you’re being treated for a skin condition but it’s not improving, contact your dermatologist. If you have HS, having the correct diagnosis as soon as possible will help prevent it from worsening and improve your quality of life.
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