Guidelines hidradenitis suppurativa
Updated on Aug 19
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The lesions are painful, erythematous, red to violaceous, infiltrated, and may or may not be suppurative. They progress by outbreaks.
Non-suppurative lesions
Nodules
Palpable lesion, firm, erythematous, spontaneously painful and/or painful to touch, diameter greater than 1 cm, elevated, flat or embedded.
Armpit Source: A. BertolottiArmpit Source: A. Bertolotti
Papules
Elevated, palpable, erythematous lesion, diameter less than 1 cm.
Posterior thigh Source: M. Moyal-Barracco
Suppurative lesions
Abscess
Accumulated pus in a nodule or cyst which is soft upon palpation. It can open at the surface spontaneously or after surgical incision.
Painful nodule with soft, fluctuant centre. Source: M. Moyal-Barracco
Same lesion a few days later (suppurative, skin opening). Source: M. Moyal-Barracco
Pustule
Small, elevated pustule with yellow, purulent contents.
Source: M. Moyal-Barracco
Face Source: MA. Richard
Sinus tract
(also called a tunnel, sinus or fistula) Linear cavity of variable length and depth, through which a liquid may pass, either spontaneously or under pressure.
Source: M. Moyal-Barracco
Inner side of the thigh Source: MA. Richard
Interconnected sinus tracts
Interconnected sinuses, with liquid discharge from several orifices. Several sinus tracts occurring in the same anatomic area, without any healthy skin, forming a suppurative mass.
Armpit Source: A. Bertolotti
Armpit Source: A. Bertolotti
Non-inflammatory lesions
These lesions are not erythematous, painful, infiltrated or oedematous. They can produce sebum, but not pus or blood.
Open comedone
Open single-pore comedone (blackhead) Source: M. Moyal-Barracco
Open multipore comedones (2 pores or more) Source: M. Moyal-Barracco
Post-inflammatory nodule
Painless nodule Source: M. Moyal-Barracco
Non-suppurative sinus, painless
Painless nodule Source: M. Moyal-Barracco
Pilonidal sinus Source: M. Serra
Cyst
Clinical presentation identical to nodule, but the term cyst supposes the existence of its own peripheral wall, observable at excision (epidermal cyst, for example).
Arm Source: A. Bertolotti
Scars
Atrophic scar
One or more depressions
“Punched-out”: round or oval depression, with distinct borders. Source: M. Moyal-BarraccoIce-pick scar: V-shaped depression. Source: M. Moyal-BarraccoCribriform: several superficial depressions across the surface of the skin. Source: Dermatology Department, Hôpital Henri Mondor, Créteil - France
Anetodermic scar
Elevated, but malleable at palpation
Source: Dermatology Department, Hôpital Henri Mondor, Créteil - France
Hypertrophic scar
Elevated, including at palpation
Area without healthy skin, forming a mass of scar tissue. Source: A. Nassif
Armpit Source: A. Bertolotti
Face Source: MA. Richard
Fleshy nodules
Source: O. CogrelSource: O. CogrelPyogenic granuloma Source: O. Cogrel
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