BS1 Intermittent Benign Course of the Disease

In more severe cases there are no days off for the patient: pain and suppuration are permanent features of their lives and the disease is relentlessly progressive in one or several areas. Inflammatory nodules rupture externally giving rise to chronic sinuses with intermittent or permanent discharge of a mixture of blood, serous exudate and pus. Who among the patients progresses to this stage of the disease cannot currently be predicted with any certainty. Neither clinical examination nor other tests offer reliable predictive data.

In the extremely severe, untreated cases, one or several affected sites are covered by a mixture of permanently draining sinus and severe scarring with oedema and limitation of mobility. The sinuses can dissect deep into the underlying tissues and go much further than can be estimated clinically. Cases have been reported where an apparent breast abscess proved to be the extension of axillary HS. Ulceration may also occur and burrowing abscesses may perforate neighbouring structures such as muscles or fascia, leading to various fistulas in the genital and perianal region. Fistula formation may involve the rectum, urethra and vagina, and has to be differentiated from fistulas arising within these organs.

In these forms the disease may manifest itself as episodes of one nodule or abscess followed by a period of remission which may last for several months; during this interval the clinical aspect is normal or one non-tender nodule may persist. The finding of such single nodules on palpation of the affected region aids the diagnosis significantly. The severity at this stage is best evaluated by the number of episode per year and the duration of each episode.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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