Hidradenitis Suppurativa: Stages, Symptoms, Cure, Treatment

Verneuil’s disease, or hidradenitis, is a chronic skin disease. The cause is unknown, which complicates the treatment and it starts with an outbreak of nodules and skin abscesses.

Hidradenitis Suppurativa: Stages, Symptoms, Cure, Treatment
Hidradenitis Suppurativa: Stages, Symptoms, Cure, Treatment

Definition: what is Verneuil’s disease?

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Verneuil’s disease, also called hidradenitis or hidradenitis suppurativa, is a chronic skin disease. It starts with the formation of painful nodules and skin abscesses.

Verneuil’s disease affects around 1% of the population and most commonly occurs after puberty. The inflammatory lesions that are caused, last for years and can get worse with time.

Symptoms: how to recognise Verneuil’s disease

The main clinical sign of Verneuil’s disease is the appearance of swollen, painful nodules (small balls underneath the skin) and abscesses (nodules full of pus) in places of the body with the most sweat glands such as the armpits, the groin and the anal region.

Parts called “body creases”, where there is heavy sweating, such as the inside of the thighs, crotch or the breasts, can also be affected. Many zones can be affected at the same time.

Verneuil’s disease evolves in outbreaks, meaning several phases of nodule formations interspersed with periods of remission. These consecutive lesions can leave permanent traces and can cause hypertrophic scars, hard areas and cracks beneath the skin. You can also see black dots (blackheads).

In some cases, Verneuil’s disease can be associated to other conditions such as Crohn’s disease, Grave’s disease or a form of severe acne.

Causes of Verneuil’s disease

The sweat glands are the glands responsible for perspiration. Verneuil’s disease develops whilst these glands are clogged by liquid or dead cells that combine with the sebum resistance. The bacteria trapped here triggers an infection.

The origin of this blockage isn’t clear as of yet, but there are some factors that could be taken into account: genetics, family history, hormones, tobacco or obesity. However, it’s not contagious or sexually transmitted.

Development of Verneuil’s disease

There are three distinct phases of Verneuil’s disease:

- Stage 1: appearance of nodules and skin abscesses without subcutaneous extension

- Stage 2: persistent abscesses and formation of fistula and hypertrophic scarring

- Stage 3: damage circulating with interconnection of abscesses and fistula traces

Treatment: how to care for Verneuil’s disease

The diagnosis of Verneuil’s disease comes quite late on, often after many years of the disease’s development, which complicates the treatment. The treatment won’t cure the disease, but is intended to manage the symptoms and limit the spread of infections. Therefore, the choice depends on the severity and the stage of the disease.

The doctor can prescribe various medication. Some antibiotics taken orally, are meant to be taken over a long period of time to fight against the bacterial infection, along with retinoid medicines, corticosteroids or immunosuppressants.

Surgical operations can be necessary if the patient has deep lesions and different techniques can be used: local removal of abscesses, externalisation of abscesses to the open-air or broad surgical excision. Even after the operation, it is recommended to stay vigilant due to the risks of the symptoms reappearing.

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