Tertiary Lesions

The final stage of the disease (Hurley stage III, see below) is characteristic and most often recognized. The chronic inflammation and pain are accompanied by a very peculiar and specific 3 form of hypertrophic fibrous scarring leading to indurated plaques in which the inflammatory nodules and sinus remains active (see Figs. 3.6, 3.7a, b). This process may involve the entire zone of apocrine-gland-bearing skin to form a subcutaneous honeycomb-like structure on clinical examination. In more lax, flexural skin (e.g. axillae), this "bridged scarring" results in thick linear, rope-like bands (see Fig. 3.6), sometimes as big as a finger, which are highly characteristic and specific for this disease. When it is severe, such scarring may decrease the mobility of

Hidradenitis Suppurativa
Fig. 3.6. Rope-like hypertrophic scar

Fig. 3.7. Severe inflamed HS; severity: Hurley's III

Fig. 3.7. Severe inflamed HS; severity: Hurley's III

Hidradenitis Suppurativa

Fig. 3.8. Severe axillary involvement with limitation of Fig. 3.9. Pubic lymphoedema in HS arm mobility

Clinical Presentation a limb, particularly abduction of the arm (see Fig. 3.8) or even produce a lymphatic obstruction with oedema (see Fig. 3.9). It is however of note that lymph node enlargement and/or inflammation is generally absent, except in cases of acute superinfection with lymphangitis.

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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