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Signs and Symptoms

One of the first steps in understanding hidradenitis suppurativa (HS) is educating yourself about the signs and symptoms of the condition. Here, you can learn about the variations of HS and view photos of patients living with HS.

  • Male
  • Female

Disclaimer: The following pages contain some graphic images. Click on the highlighted parts of the body to see images of mild, moderate and severe cases affecting that area.

Click on the highlighted parts of the body to see images of mild, moderate and severe cases affecting that area.

VIEW FRONT SIDE SYMPTOMS

VIEW BACK SIDE SYMPTOMS

    UNDERARM

  • Small nodules located in the armpit of a person with mild HS.

  • Several small nodules and mild scarring found in the armpit.

  • Several nodules and evidence of moderate scarring in the armpit.

  • An area of moderate scarring with associated sinus tracts involving the armpit.

  • A person with moderate HS showing signs of scarring and sinus tract formation in their armpit.

  • Scarring over small nodules in the armpit of a person with moderate HS.

  • Scarring and draining of multiple holes connected via sinus tracts in the armpit of a person with moderate HS.

  • A draining pustule in the armpit of a person with moderate HS.

  • Scarring and draining of multiple sinus tracts in the armpit of a person with severe HS

  • Severe inflammation as a result of large sinus tracts in the armpit of a person with severe HS.

    UNDERARM

  • Small nodules located in the armpit of a person with mild HS.

  • Several small nodules and mild scarring found in the armpit.

  • Several nodules and evidence of moderate scarring in the armpit.

  • An area of moderate scarring with associated sinus tracts involving the armpit.

  • A person with moderate HS showing signs of scarring and sinus tract formation in their armpit.

  • Scarring over small nodules in the armpit of a person with moderate HS.

  • Scarring and draining of multiple holes connected via sinus tracts in the armpit of a person with moderate HS.

  • A draining pustule in the armpit of a person with moderate HS.

  • Scarring and draining of multiple sinus tracts in the armpit of a person with severe HS

  • Severe inflammation as a result of large sinus tracts in the armpit of a person with severe HS.

    GROIN

  • Small nodules and mild residual scarring in the groin of a male.

  • Slight scarring as a result of small nodules on the groin of a male with mild HS.

  • A small nodule and initial sinus tract development in the groin of a male with mild HS.

  • Mild scarring appears in a male's groin in the aftermath of nodules.

  • A cluster of nodules connected via sinus tracts involving the groin of a male with moderate HS.

  • Moderate abscesses found in the groin of a male.

  • A series of nodules in the groin of a male with moderate HS.

  • A cluster of ruptured, draining abscesses involving the groin of a male with moderate HS.

  • A cluster of ruptured, draining abscesses in the groin of a male with severe HS.

  • Scarring over sinus tracts accompanied by several open lesions in the groin of a male with severe HS.

    BUTTOCKS

  • Nodules and mild scarring on the buttocks.

  • Mild scarring over nodules on the buttocks of a male.

  • A large cluster of moderately-sized nodules on the buttocks of a male.

  • Light scarring over small nodules on the buttocks of a male with moderate HS.

  • A small cluster of nodules involving the perianal region of a male with moderate HS.

  • Mild residual scarring on the buttocks.

  • Small nodules involving the perianal region of a male with moderate HS.

  • Mild scarring over sinus tracts involving the buttocks of a male.

  • Large nodules on the upper buttocks of a male with moderate HS.

  • Severe scarring over sinus tracts.

Disclaimer: The following pages contain some graphic images. Click on the highlighted parts of the body to see images of mild, moderate and severe cases affecting that area.

Click on the highlighted parts of the body to see images of mild, moderate and severe cases affecting that area.

VIEW FRONT SIDE SYMPTOMS

VIEW BACK SIDE SYMPTOMS

    UNDERARM

  • Small nodules located in the armpit of a person with mild HS.

  • Several small nodules and mild scarring found in the armpit.

  • Several nodules and evidence of moderate scarring in the armpit.

  • An area of moderate scarring with associated sinus tracts involving the armpit.

  • A person with moderate HS showing signs of scarring and sinus tract formation in their armpit.

  • Scarring over small nodules in the armpit of a person with moderate HS.

  • Scarring and draining of multiple holes connected via sinus tracts in the armpit of a person with moderate HS.

  • A draining pustule in the armpit of a person with moderate HS.

  • Scarring and draining of multiple sinus tracts in the armpit of a person with severe HS

  • Severe inflammation as a result of large sinus tracts in the armpit of a person with severe HS.

    UNDERARM

  • Small nodules located in the armpit of a person with mild HS.

  • Several small nodules and mild scarring found in the armpit.

  • Several nodules and evidence of moderate scarring in the armpit.

  • An area of moderate scarring with associated sinus tracts involving the armpit.

  • A person with moderate HS showing signs of scarring and sinus tract formation in their armpit.

  • Scarring over small nodules in the armpit of a person with moderate HS.

  • Scarring and draining of multiple holes connected via sinus tracts in the armpit of a person with moderate HS.

  • A draining pustule in the armpit of a person with moderate HS.

  • Scarring and draining of multiple sinus tracts in the armpit of a person with severe HS

  • Severe inflammation as a result of large sinus tracts in the armpit of a person with severe HS.

    GROIN

  • Small nodules involving the groin of a female with mild HS.

  • An area of mild scarring and associated fistulas involving the groin.

  • A series of mild nodules in the groin.

  • A female with severe HS exhibiting scarring and sinus tract formation in the groin.

  • Multiple small nodules in the groin of a female with mild HS.

  • Open lesions in the groin of a female with moderate HS.

  • A cluster of nodules connected via sinus tracts in a female with severe HS.

  • Moderate sinus tract formation and scarring in the groin.

  • Nodules and evidence of moderate scarring in the groin.

  • Several large nodules involving the groin of a female with moderate HS.

    BUTTOCKS

  • Mild residual scarring on the perianal region of a female.

  • Mild scarring and nodules on the buttocks of a female.

  • Mild scarring over small nodules on the buttocks.

  • Mild scarring on the buttocks of a female.

  • Mild scarring on the buttocks of a female.

  • Presence of lesions and draining of ruptured nodules on the buttocks of a person with severe HS.

  • Severe inflammation of the genitals and perianal region of a female.

  • Sinus tract formation and large nodules in the perianal region of a person with severe HS.

  • Moderate scarring over nodules involving the perianal region of a female.

  • Several large fistulas connected by sinus tracts in the perianal region of a female with severe HS.

    BREAST

  • A female with mild HS experiencing a small nodule in the breasts.

  • Small abscesses and mild scarring in a female’s breast area.

  • Inflamed abscesses under the breast of a female with moderate HS.

  • A series of moderate scars and spots (lesions) on the side of a female's breast

  • A small, open lesion on the breast of a female with moderate HS.

  • A female with severe HS exhibiting scarring and draining of lesions under the breast.

  • Scarring and draining of multiple fistulas connected via sinus tracts on the breast of a person with severe HS.

  • A large, open lesion on the breast of a female with severe HS nearby a sinus tract formation.

  • Residual scarring on the breast of a female with severe HS.

  • Lesions and scarring of a cluster of fistulas involving the breasts of a female with severe hidradenitis suppurativa.

Please choose a different body part.smallTriangle

Because HS is often mistaken for an infection or acne, a delay in diagnosis is not uncommon.1,2  Specialist GPs and Dermatologists typically usually grade the signs and symptoms of HS, according to how severe they are, on a scale called the Hurley scale:1

Mild cases

Single or a few isolated spots without skin tunnelling (sinus tracts) or scarring1,2
  • Painful bumps, pustules and abscesses in the armpits, groin, under the breasts, in between the buttocks or inner thigh
  • These bumps generally start as firm, pea-sized nodules3

Moderate cases

Recurring spots, pustules and abscesses in multiple areas with scarring and skin tunelling1,2
  • Scarring: scarring can occur with HS as a result of long-term or repeat occurrences in a single location3

Severe cases                          

Widespread spots, pustules and abscesses with multiple interconnected skin holes and tunels (sinus tracts)1-4
  • Abscesses can be painful and develop into deep sinus tracts under the skin. Areas of skin involved may rupture and emit an unpleasant smell3

 

Not all cases of HS increase in severity over time (called 'progressive'). However, some cases may grow more severe over time. As a result, diagnosing and managing HS as early as possible is important.2,4 The first step for HS patients is to speak to your family GP to help ensure an early and accurate diagnosis.

If you think you may have HS, it's important to talk to your GP without fear of embarrassment. Some GPs take a special interest in skin conditions. Because HS is not a widely known disease, some GPs may then refer you to a specialist in dermatology at your local hospital. Visit our 'Talking to Your GP' section for information and tips to help guide a discussion with your doctor.

Talking to Your GP

TTYD

If you think you may have hidradenitis suppurativa (HS), seeing your family doctor for an accurate diagnosis and useful information is an important first step in managing your condition.

FIND OUT MORE

REFERENCES:

  1. Jemec G. Hidradenitis Suppurativa. N Engl J Med. 2012; 366:158-64.
  2. Zouboulis CC, Tsatsou F (2012) Disorders of the apocrine sweat glands. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K (eds) Fitzpatrick’s Dermatology in General Medicine. 8th ed, McGraw Hill, New York Chicago, pp 947-959.
  3. Mayo Health Clinic. Hidradenitis Suppurativa. Available at: http://www.mayoclinic.com/health/hidradenitis-suppurativa/DS00818. Published April 9, 2013. Accessed October 2nd, 2014.
  4. Collier F., Smith R., Morton C. Diagnosis and management of hidradenitis suppurativa. BMJ. 2013; 346:f2121.

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The content on this site has been created solely for UK residents. It is intended for informational purposes only, and should not be used to replace a discussion with a healthcare professional. All decisions regarding patient care must be handled by a healthcare professional, and be made based on the unique needs of each patient.

AXHUD141459a Date of Preparation Nov 2014

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