February 09, 2007

Hidradenitis Suppurativa , Impetigo


Hidradenitis Suppurativa
Hidradenitis suppurativa is inflammation of the apocrine sweat glands resulting in painful accumulations of pus under the skin.

Hidradenitis suppurativa develops in some people after puberty because of chronic blockage of the apocrine sweat glands (the specialized sweat glands under the arms, in the genital area, around the anus, and under the breasts). Doctors do not know why the blockage occurs, but it is not related to the use of deodorants or powders or to underarm shaving. The blockage causes the glands to swell and rupture, frequently leading to infection by various bacteria. The abscesses (pus-filled pockets) that result are painful and foul smelling and tend to recur. After several recurrences, the skin in the area becomes thick and scarred.

Hidradenitis suppurativa resembles common skin abscesses. A doctor makes the diagnosis based on the location of the abscesses and on the fact that they recur often.

For people with mild cases, a doctor injects corticosteroids into the area and prescribes antibiotics, such as tetracycline or erythromycin , to be taken by mouth. Clindamycin applied topically is also effective. In some cases, a doctor cuts open the abscesses to drain the pus. For severe cases, isotretinoin , an anti-inflammatory drug, may be given by mouth. Laser treatment has also been used. In severe cases, cutting out the involved area followed by skin grafting may be necessary.


Impetigo is a skin infection, caused by Staphylococcus aureus, Streptococcus pyogenes, or both, that leads to the formation of scabby, yellow-crusted sores and, sometimes, small blisters filled with yellow fluid.

Impetigo is common. It affects mostly children. Impetigo can occur anywhere on the body but most commonly occurs on the face, arms, and legs. The blisters that may form (bullous impetigo) can vary from pea-sized to large rings and can last for days to weeks. Impetigo often affects normal skin but may follow an injury or a condition that causes a break in the skin, such as a fungal infection, sunburn, or an insect bite.

Impetigo is itchy and slightly painful. The itching often leads to extensive scratching, particularly in children, which serves to spread the infection. Impetigo is very contagious—both to other areas of the person's own skin and to other people.

The infected area should be washed gently with soap and water several times a day to remove any crusts. Small areas are treated with bacitracin ointment or mupirocin cream or ointment. If large areas are involved, an antibiotic taken by mouth, such as a cephalosporin, may be needed.

Adapted from: Merck & Co., Inc