Q: I am 37y old and have a complicated skin problem for the last four years. I keep sweating allover the body and get infection in my arm pit and groin which sometimes turns into boils and forms pus. I have shown this problem to a dermatologist who, after checking my pus, confirmed that I was having infection of apocrine glands known as hidradinitis suppurativa. I am taking Finast 1mg for the last one year but the problem still exists. Kindly provide me the correct treatment for this problem.

A:Hidradenitis is a chronic disease of the scent or apocrine glands which causes chronic scarring and pus formation of the axillae and groin areas. It is similar to acne which is a disease of the oil glands. Hidradenitis usually starts as one or more red, tender, swellings in the groin or axilla. Over a period of hours to days the lesions enlarge and often open to the skin surface draining clear to yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission. For unknown reasons, people with hidradenitis develop plugging or clogging of their apocrine glands. This leads to bacterial infection which can produce pain and odor. Hidradenitis is made worse by being overweight, however this condition is not caused by obesity. Hidradenitis is more common in people who have had acne. Hidradenitis may become worse under stress. Hidradenitis is not caused by poor hygiene. TREATMENT: Topical antibiotics (applied to the skin) are the treatment of choice. Oral antibiotics (erythromycin,tetracycline,minocycline etc)are at times necessary when the condition is flaring or when a patient has a severe case. Isotretinoin Intralesional steroids Tight-fitting clothing is to be strictly avoided. Dirt does not cause hidradenitis. The involved areas should be cleaned daily using an antibacterial soap which can help reduce the odor associated with this condition. There is no medical cure for hidradenitis. Hidradenitis can be controlled, but not cured. Sometimes surgery is required to drain infected areas or to remove scarred tissue or even large areas of skin. Weight loss will improve but not cure hidradenitis. Surgical consultation may be obtained for removal of sinus tracts, curettage, and exteriorization of the gland. Excision and skin grafting may be helpful for severe cases. The CO2 laser has been used to strip away glandular tissue.