Hidradenitis Suppurativa: Diagnosis and Management in the Emergency Department

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic immune-mediated inflammatory skin disease characterized by abscesses and inflammatory nodules, and occasionally tunnels and scars, in the axillae, groin, and inframammary areas.

Objective: HS can be challenging to diagnose because it mimics localized soft-tissue infection. The process of differentiating HS from soft-tissue infection is discussed. Patients with HS frequently visit emergency departments (EDs) for acute management of pain and drainage from HS lesions. This review updates emergency and urgent care physicians on how to educate and initiate treatment for patients with HS, and to coordinate care with dermatologists and other physicians early in their disease course.

Discussion: Recent updates on the epidemiology, diagnosis, and management of HS are reviewed.

Conclusions: Practice variations between how care for HS is provided in the ED setting and what HS treatment guidelines recommend are identified.

Keywords: Diagnosis; Epidemiology; Hidradenitis suppurativa; Pain management; Skin surgery.