Multiple abscesses are a rare disease of the skin and subcutaneous tissue in the course of which purulent bumps appear, prone to scarring. The disease appears after adolescence and most often affects people aged 20-25. What are the causes and other symptoms of multiple abscesses? What is the treatment?

Multiple abscessesarmpit (Latinhidradenitis suppurativa ) is a disease of the skin and subcutaneous tissue that affects the hair follicles, i.e. a narrow tube in skin from which hair grows. In the course of the disease, they become inflamed, and then abscesses, fistulas and scars develop. In a few percent of patients, purulent inflammation of the apocrine glands, i.e. sweat glands, located on the skin around the armpits, groin, anus, nipples and eyelids secondarily develops.

Other terms for this disease include inverted acne, i.e. inverted folliculitis (Latinacne inversa ), Velpeau's disease or Verneuil's disease.

Multiple abscesses are also called purulent apocrine inflammation, but this is a misnomer as apocrine inflammation is only one component of the disease.

Multiple abscesses - causes and risk factors

The most common cause of multiple abscesses is bacterial infection (usually staphylococcus) of the apocrine sweat glands, i.e. glands that become active only after puberty. Therefore, the disease affects adults - it usually begins in people aged 20-25 ( although there are known cases of the development of multiple abscesses in newborns).

It is suspected that the disease may also be the result of an immune disorder or be hereditary (cases of familial occurrence have been reported).

In addition, there are many risk factors for developing multiple abscesses. Among them, the hormonal ones play an important role, as evidenced by the fact that the disease usually begins after puberty and partially (or completely) disappears after the menopause. Smoking is another important factor, as it has been noticed that the disease often affects people who have smoked for many years. There is also a link between diabetes and obesity and the development of multiple abscesses.

Other risk factors are: excessive sweating, failure to follow basic hygiene rules, acne, oily skin, etc.inflammatory skin diseases, tight-fitting clothes, excessive shaving, use of epilators and deodorants.

Multiple abscesses - symptoms

Initially, folliculitis, blackheads, papules and pustules appear.

In women, changes occur most often in the armpits, and in men, in the groin and around the anus

Then painful purulent nodules or subcutaneous tumors / cysts develop and break through spontaneously from time to time. Then purulent discharge oozes from the lesions.

Wounds created in this way heal very slowly or not at all, which in the later stage of the disease leads to the formation of fistulas and further scars. The accompanying symptoms are itching and burning of the skin.

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Multiple abscesses - diagnosis

Blood tests are performed (in the case of multiple abscesses, it is found, among others, increased ESR and the level of acute phase proteins) and bacteriological tests.

A histopathological examination of the changes should also be performed to exclude squamous cell carcinoma of the skin. In addition, the doctor should check whether the cause of the above-mentioned skin lesions can be caused by other diseases, e.g. boils, skin spreading tuberculosis. If abscesses appear in the perianal area, Cushing's disease should be ruled out, as such changes are sometimes the first symptoms of this disease.

Multiple abscesses - treatment

The patient can be given antibiotics - both orally and topically (in the form of ointments). However, as shown by the experience of doctors, this type of treatment is ineffective. Therefore, the most commonly used treatment is the excision of the diseased areas along with the he althy tissue margin. If the wound is quite large, a skin graft may be necessary.

Important

Multiple abscesses - complications

Untreated disease can lead to the development of Fournier's syndrome (necrotic infection - gangrene - around the perineum), amyloidosis, and even sepsis. If the lesions are located around the anus, an anal fistula may form. In addition, about 3 percent. cases, the disease can turn into cancer.

Category:

Dermatology