Topic 1: HS Is More Than ‘Recurrent Boils’
Hidradenitis suppurativa, or HS, is a chronic inflammatory disease involving the hair follicle. It most often produces recurrent, painful inflammatory lesions in intertriginous areas. Early lesions may be described by patients as boils, cysts, ingrown hairs, or infections. This language can lead clinicians to focus on the current lesion rather than the recurring pattern.1
HS is diagnosed clinically. No laboratory test, bacterial culture, or biopsy result confirms HS. Instead, recognition depends on the combination of:
- Characteristic lesion morphology
- Typical anatomic distribution
- Recurrence or chronicity
A patient does not need to have tunnels, extensive scarring, or numerous active lesions to have HS. These findings generally reflect structural damage or more established disease and should not be treated as prerequisites for diagnosis.1
Clinical pearl: When a patient reports another ‘boil’ in an axilla, groin, inframammary fold or buttock, ask about previous episodes before assuming that the lesion is an isolated infection.
