Hydradenitis antibiotics. Ointments, antibiotics and folk remedies for bitch udders. Sour cream and rye flour

Therapy at the initial stage of development of hydradenitis

Hydradenitis is better not to run

For initial stage development for hidradenitis is characterized by subcutaneous compaction, causing a painful sensation. If the disease is recognized in time and measures are taken, the node may resolve. To do this, it is necessary to treat the affected area according to the following scheme:

the hair is carefully removed with small scissors.
to relieve inflammation and disinfect the affected area, you need to apply calendula tincture on alcohol or salicylic acid solution to the skin a couple of times a day;
1-2 times a day, it is necessary to apply lotions to the affected area (a swab moistened with chlorophyllipt);

Possible consequences of inflammation

If the treatment of hidradenitis was delayed or carried out incorrectly, then the disease can eventually lead to some serious complications. So, complications of hidradenitis can be lymphadenitis, abscess, phlegmon, sepsis.

Complications of the disease are:

Inflammation of the lymphatic vessels and lymph nodes.
On the side of hidradenitis, sometimes lymphedema develops - soft tissue swelling upper limb on the side of hydradenitis.
With the spread of inflammation to the subcutaneous tissue, phlegmon develops.

Rice. 8. In the photo, the consequences of hydradenitis in the armpit are hypertrophic and keloid scars.

Rice. 9. At the site of inflammation, ugly, retracted scars often form.

Rice. 10. In the photo, inflammation of the lymphatic vessels, as a result of a boil, carbuncle, abscess or hydradenitis.

Staphylococcal infections are among the most resistant and difficult to treat types of inflammation. Therefore, do not wait for the swelling to resolve by itself. On the forums devoted to the issues of skin diseases, there are many photos showing hydradenitis at various localizations.

The point is that in armpits, groin located lymph nodes. And infection of the sweat glands has a tendency to abscess flow. That is, a solid core is not formed, as, for example, with boils, but nearby tissues are involved in the process. Infection in the lymph nodes is fraught with the development of severe lymphadenitis.

Even after opening the abscess, you will have to go to the doctor. Pathogenic microflora still remains in the cavity of the sweat gland. It becomes the cause of chronic hidradenitis, which is characterized by recurrent development with periods of exacerbation.

In addition, a course of antibiotics is likely to help at an early stage. However, if there is a large abscess, surgery is required to prevent complications of hidradenitis.

Note: Remember that with such a serious disease as hidradenitis, treatment at home can lead to the development of severe complications.

If, with hydradenitis, the process turned out to be started and an abscess formed, which was not opened in a timely manner, complications such as lymphadenitis, phlegmon and sepsis are possible. Blood poisoning often causes death.

Choice of drug, possible side effects and price

The choice of antibiotic directly depends on the pathogen that led to the inflammation.

The most common cause of hydradenitis is the following bacteria:

Staphylococci;
Streptococci;
Proteus, Pseudomonas, Escherichia coli (in rare cases).

All of the above bacteria are conditionally pathogenic microflora. They live on the surface of everyone's skin healthy people and this situation does not require treatment. With a decrease in immune forces, hypothermia, severe diseases of internal organs, bacteria can cause disease. One of them is hydradenitis.

It is known that most of microorganisms are resistant to penicillin. This drug is not used for hydradenitis.

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The choice of antibiotic is based on the likely pathogen and other antibiotics ever taken. One of the most effective are cephalosporins.

Conservative treatment is used only at the stage of infiltration. In the presence of a cavity with pus, the first step is to open and drain, followed by medication.

Side effects

Given that antibiotics affect all tissues of the body, and not just the purulent focus, they cause complications. Side effects develop more often in such cases:

in childhood;
in the elderly;
in violation of the function of the liver, kidneys;
after prolonged use;
in the presence of diseases of the stomach and intestines;
when using high doses;
with individual hypersensitivity.

To prevent anaphylactic shock and Quincke's edema, a sensitivity test is mandatory before the administration of cephalosporins.

From the urinary system and kidneys - a toxic effect with the development of their insufficiency.

Pain in the muscles.

On the part of the hematopoietic organs - anemia, thrombocytopenia.

The impact on the gastrointestinal tract is manifested in the form of dysbacteriosis, abdominal discomfort, constipation, diarrhea, flatulence.

Hidradenitis - causes, symptoms, diagnosis and treatment

A certain role in the development of infection is played by the properties of the pathogen itself. The high virulence of staphylococcus aureus, the toxins it releases, facilitates its penetration and reproduction in the cavity of the sweat gland.

scratching of the skin allergic itch, insect bites, cuts, scratches due to careless shaving;
the use of soap, shower gels, cosmetics, which violates the pH of the skin, normally its level is in the range of 4.5 - 5.5, thus inhibiting reproduction pathogenic flora, with an increase in this value, this defense mechanism violated;
a change in the hormonal background leads to an increase in the secretion of sweat and sebum;
hyperhidrosis caused by prolonged fever, stay in a hot climate, hard physical work, psychological stress;
ingrown hair after epilation;
diaper rash arising from improper selection of clothing, non-compliance with hygiene;
the use of deodorant and powders that clog the pores of the skin;
peculiarities anatomical structure ducts of sweat glands, too curved tubule contributes to the accumulation of keratinized particles of the epidermis and fatty acids.

However, the main causes of infection are a violation of the immune system and local defense factors. A similar condition develops against the background of constant stress, the presence of foci of chronic "smoldering" infection in the body, HIV.

Immunity weakens after operations, especially if they were accompanied by massive blood loss. Long-term use of corticosteroids, cytostatics, antibacterial agents, chemotherapy also inhibit the functioning of the immune system.

The protective properties of the skin weaken with the frequent use of bactericidal hygiene products. Addiction to such soaps and gels and the skin diseases they cause have led to a ban on their sale in some foreign countries.

Inguinal hydradenitis, as well as axillary, develops quite often due to the location of many sweat glands in the designated area. Purulent cones of hydradenitis ripen in the groin according to the same scenario as in the armpits. The reasons for the appearance are usually:

poor hygiene
heavy sweating
sloppy shave
ingrown hairs
hormonal disruptions
wearing tight synthetic shorts

IMPORTANT: Inguinal hidradenitis often acquires chronic recurrent forms. Due to the "intimacy" of the disease, not everyone turns to the doctor, losing precious time and contributing to further development and spread of hydradenitis.

The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician.

Mostly women suffer from hydradenitis. Their disease is localized in the armpits. This is due to the fact that they pay more attention to the aesthetic side of the skin and injure it when shaving and epilating. In men, the groin area is more often affected.

there is a pathogen on the skin;
reduced protective properties of the skin;
weakened general immunity.

Let's take a closer look at each of the points.

Staphylococcus aureus

Epidermal staphylococcus inhabits the skin and mucous membranes of a person without causing disease. It is considered an opportunistic bacterium, and normal immunity can easily cope with it. In weakened people causes pustular skin diseases.
Staphylococcus saprophyticus is a permanent inhabitant of the skin. But in immunocompromised women, it can cause urethritis and cystitis.
Staphylococcus aureus is very dangerous bacterium, which provokes serious illness: sore throat, pneumonia, sepsis. However, 20% of people can coexist with her. This staphylococcus lives in their mouth and nose without causing disease.

Skin properties

To maintain normal skin acidity and prevent purulent inflammation, it is better to use hygiene products with low level pH containing lactic acid.

Since women are years old from hormonal imbalances, it is they who most often turn to doctors with hydradenitis.

Violations of the formation of the apocrine duct in the embryonic period. Abnormal structure of the sweat gland: its duct is too narrow or tortuous. It is often clogged with thickened sebum and keratinized skin scales, which leads to repeated inflammation of the gland.

Exhaustion of the body, which is a consequence of:
- excessive physical and mental stress;
- acute infectious diseases and poisonings;
- insomnia;
- injuries and operations;
- burns;
- blood loss;
- chronic stress.

The strength reserves of the body are exhausted and all functions are violated. Including insufficient quantities are produced immune cells, which are designed to fight bacteria - leukocytes and lymphocytes.

Pathogens deplete immune system, disrupting the division of its cells. Toxins of microorganisms cause poisoning of the body and weaken it.

Taking these drugs causes a decrease in the production of white blood cells and T-lymphocytes.

These pathologies are genetic defects. They form during prenatal development and cause immune dysfunction. Lymphocytes and leukocytes are produced in insufficient quantities or do not perform their functions.

During these diseases, immune cells do not attack bacteria, but the cells of their own body. In addition, the treatment of these pathologies is aimed at reducing the activity of the immune system.

Reduced energy production in these diseases leads to a slowdown in the division of cells of the immune system.

in the duct of the sweat gland, a horny plug is formed from epithelial cells and secretions of the glands;
the duct and gland expand under the pressure of accumulated sweat;
bacteria multiply in the gland (those that have entered from the surface of the skin or brought in with the current of lymph) and inflammation begins;
the gland ruptures and the infection spreads to surrounding tissues;
a wall is formed around the hearth connective tissue, which limits the cavity filled with pus;
after the opening of the cavity and the release of pus, fibrin is deposited on its walls and fistulous passages are formed.

Hydradenitis - purulent inflammation apocrine sweat glands. The disease develops gradually. The first few days, the inflamed gland is a dense, painful nodule the size of a pea.

After 5-7 days, it increases in size up to 2-3 centimeters and acquires a pear-shaped shape. The abscess outwardly resembles a nipple, which is why the people called the disease “bitch's udder”. The armpits are predominantly affected.

The inguinal region suffers less often: the labia majora in women and the scrotum in men, as well as the area around the anus. There are cases of inflammation of the sweat glands around the nipples and in the scalp.

The disease is most often caused by Staphylococcus aureus. But in some cases, streptococcus or E. coli can become the culprit of inflammation. Bacteria enter the sweat gland through a duct from the surface of the skin.

Hydradenitis affects people of all nationalities. But in people of the Negroid race, the symptoms are more pronounced. Mostly women suffer from hydradenitis. Their disease is localized in the armpits.

This is due to the fact that they pay more attention to the aesthetic side of the skin and injure it when shaving and epilating. In men, the groin area is more often affected. In children under adolescence, hidradenitis does not occur, since apocrine sweat glands They only start working during puberty.

There are cases when in the family the tendency to hydradenitis is inherited. This is due to the peculiarity of the structure of the sweat glands: their ducts are short and wide. People with hereditary hidradenitis often have an epithelial coccygeal duct and abscessed acne.

The skin is the largest and most complex organ of the human body. Its area reaches 2 sq.m. The skin consists of 3 layers, each of which performs its function:

Epidermis, thickness 0.1-1 mm. It consists of five layers, each of which differs in the structure of cells. The lower layers provide the epidermis with new cells and are responsible for the healing of minor skin lesions. The upper stratum corneum consists of dead keratinized cells. They are responsible for the mechanical protection of the skin and do not let pathogenic microorganisms into the deep layers. The ducts of the skin glands pass through the epidermis.
The actual skin or dermis. Consists predominantly of connective tissue and has 2 layers
- The papillary layer is located under the epidermis. Nerve endings and loops of blood capillaries are located in its papillary outgrowths.
- mesh layer. Among the cells of the connective tissue are blood and lymphatic vessels, nerve endings. In its thickness are hair follicles, sebaceous and sweat glands. There are also collagen and muscle fibers that are responsible for the firmness and elasticity of the skin.
Subcutaneous fat or hypodermis. Follow the loosely located bundles of connective tissue, accumulations of fat cells lie. This layer of skin performs the function of additional protection against damage, temperature changes and storage of nutrients.

Skin appendages are nails, hair and various glands.

The sebaceous glands produce sebum. The fatty substance forms a protective lipid layer that prevents water from penetrating into the skin. This is necessary because bacteria enter the skin along with water. The glands lie superficially and have a cellular structure. Their mouths open into hair follicles. Quantity sebaceous glands exceeds 3.5 million. They produce 20 g of sebum per day.
Sweat glands produce sweat. They have a simple tubular structure. The lower secretory part, where sweat is formed, is a tube rolled into a ball. It is located deep in the dermis. The excretory duct is a straight tube that carries sweat to the surface of the skin or to the mouth of the hair follicles, next to the sebaceous gland duct. The number of sweat glands in the skin exceeds 2.5 million. At an average temperature, up to 800 ml of liquid and 40 g of salt per day are released through them.

Hydradenitis. Causes, symptoms, diagnosis and treatment of the disease.

How to treat hydradenitis? The disease will not go away on its own, so medical intervention is required. Sweat center and skin problems are dealt with by a surgeon and a dermatologist.

If inflammation is detected, first aid must be provided:

Gently get rid of hair from neighboring places.
Avoid moisture, so do not take a bath. You can take a shower, but the sore spot must be sealed with adhesive tape.
Warm the nodules every hour with a warm towel.
Warm up the inflammation with a blue lamp for 5 minutes 3 times a day.
Wipe the nodes and skin around with alcohol several times a day.

These measures will help to heal faster and will not allow pus to pass deep into the body.

Hydradenitis itself is not contagious. However, an infection that comes out with purulent contents can be transmitted. Therefore, you can not touch personal hygiene items and clothes of the patient.

Medicines

Medicines have the most intense and directed action. The main assets include:

Alcohol, which is used after opening the cones to prevent the spread of infection. Suitable camphor (10%) or boron (2%).
Vishnevsky's ointment for hydradenitis is the most popular and frequently prescribed remedy. It contributes to the rapid maturation of the cone, which ensures its spontaneous opening.
Ichthyol ointment is an important drug. During the entire disease, bandages can be made from it. As the bump opens, the bandage should be changed very often.
Levomekol with hydradenitis is used when the skin is completely freed from impurities. It will disinfect the wound and allow it to heal faster.
Hydrogen peroxide is great for handling buds after opening.

Antibiotics for hydradenitis are prescribed for severe inflammation. The disease seriously affects the body, and such medicines prevent the spread of infection and the occurrence of complications.

Of the antibiotics, macrolides, Erythromycin, Tetracycline can be prescribed. If observed fever Antipyretic drugs (Ibuprofen, Paracetamol) are prescribed.

If the bump opens, and the installation of drainage does not bring results due to the appearance of many small abscesses in the focus of the infiltrate, then the surgeon makes a deep incision to healthy tissues.

When the wound heals, antibiotics and physiotherapy are prescribed. This way, relapses can be avoided. The physiotherapy course includes the following methods:

photochemotherapy (increases the body's resistance to pathogenic bacteria);
quartz;
IF-therapy (stops pain in the armpits);
magnetic laser therapy (has anti-inflammatory and analgesic effect).

Autohemotherapy is also used. If the patient has recurrent forms of hidradenitis, then they are used for treatment. specific immunotherapy, prescribe drugs that have a general strengthening effect.

As a means for local therapy hydradenitis successfully used ichthyol cake. During the period when pus is released from the nodes, it should be changed twice a day. At this time, UHF is used for treatment, dry heat, ultraviolet irradiation as well as exposure to the sun.

To do this, you can use folk or medications. It is necessary to start treatment immediately after the discovery of a seal.

At the stage of abscess formation, surgical treatment is used. Antibiotics and means of pathogenetic therapy accelerate recovery.

Treatment of a recurrent (chronic) form of hidradenitis includes the use of specific and non-specific agents that increase the body's defenses.

The hair in the armpit is shaved off.
The skin is treated twice a day with a solution of 70% ethyl alcohol.

Aniline dyes are used: a solution of fucorcin (Castellani liquid), a solution of brilliant green (brilliant green).

Keratoplastic agents are used. Preparations of this group have the property of drying tissues. Taking away water, they help to slow down the processes of fermentation and putrefaction in deep inflammatory infiltrates. Application shown 20% Ichthyol ointment or pure Ichthyol. An “ichthyol cake” is applied to the affected surface twice a day (the applied ointment is covered with a thin layer of cotton wool).
Acceleration of the resolution of the inflammatory infiltrate is achieved by introducing Triamcinolone glucocorticoid at a dose of 3-5 mg / ml into the lesion and injecting with antibiotics.
During the ripening period of the boil, physiotherapy is indicated (UHF therapy, dry heat).

Rice. 12. In the photo, the consequences of hydradenitis in the groin.

How to treat hydradenitis? Mandatory procedures that do not allow the infectious process to spread to healthy neighboring areas:

An abscess localized anywhere is recommended to be treated twice a day with boric or salicylic acid. You can use tincture of calendula.
Apply cotton wool soaked in a solution based on iodine and Dimexide. You can just make an iodine grid.
It is allowed to apply a gauze bandage soaked in antiseptics. The bandage is fixed with a plaster. As it dries, a new medicine is applied. The duration of the procedure is about three hours. Dioxidine has a healing property, alcohol solution Chlorophyllipta, tincture of calendula. All these solutions should be diluted with water before use.
Ointments Levomekol, Clindamycin, Levosin, Ichthyol cream will help reduce the signs of the disease.

Antibiotics for hydradenitis are not always prescribed and only by a doctor. The main problem is that the infectious agents that cause hidradenitis are resistant to most antibiotics. An experienced doctor, if necessary, will be able to choose the most suitable antibiotic therapy, the patient herself will not be able to do this.

Basic principles of prescribing antibiotics for purulent hydradenitis

Even ancient doctors treated purulent-inflammatory diseases of soft tissues with the help of antibacterial agents of natural origin, selecting them empirically. This problem is no less relevant today, when doctors have powerful antibiotics at their disposal.

There is extensive clinical experience in the treatment of purulent hidradenitis with antibiotics. This experience shows that not everything is so simple: pyogenic bacteria quickly get used to one or another antibiotic. , to some they are completely initially resistant (immune).

Therefore, antibiotics for hydradenitis should be prescribed taking into account the patient's condition, the state of his immunity, the stage of the disease, the characteristics of the infectious agent and its sensitivity to antibiotics. It must be remembered that antibiotics do not replace surgical intervention if the patient has already formed an abscess.

The causative agents of purulent hydradenitis are most often different kinds staphylococci, which have completely lost sensitivity to antibiotics of the first generation (penicillin, tetracycline , chloramphenicol) due to their mutagenic action. Antibiotics of the latest generations are also not always effective in the treatment of purulent hidradenitis, so the doctor sometimes has to select them individually for each patient, sometimes prescribing several combined antibiotics and other antibacterial drugs.

Given all these nuances, the decision on how to treat hydradenitis under the arm should only be taken by a surgeon. Self-treatment with the help of antibiotics purchased at the pharmacy should be completely excluded.

The most effective antibiotics for purulent processes in soft tissues

For the treatment of purulent hidradenitis, antibiotics of different groups are used today:

antibiotics of the tetracycline group - most often it is modern drug doxycycline; tetracyclines inhibit protein synthesis in staphylococcal cells, thus preventing their reproduction;
antibiotics of the macrolide group - Azithromycin, Jozamcin, Clarithromycin; suppress the vital activity of staphylococcus aureus side effects;
antibiotics of the cephalosporin group - Ceftriaxone, Cephalexin; destroy bacterial cells by destroying their membranes;
semi-synthetic penicillins - Oxacillin, Methicillin, Dicloxacillin; Ampicillin, Carbenicillin; actively suppress the vital activity of staphylococci;
antibiotics from the group of aminoglycosides - Gentamicin, Kanamycin, Amikacin;
antibiotics from the group of lincosamides - Lincomycin, Clindamycin; inhibits intracellular protein biosynthesis of bacteria;
semi-synthetic broad-spectrum anti-tuberculosis antibiotic Rifampicin; inhibits enzymes involved in the synthesis of proteins in bacterial cells;
antibacterial drugs of the fluoroquinolone group - Ciprofloxacin, Ofloxacin, Levofloxacin; destroy bacterial cells by inhibiting protein synthesis.

Various combinations of antibiotics are used to treat severe hidradenitis. The doctor can always find how to treat hydradenitis. The following combinations of antibiotics are most commonly used for staphylococcal infections:

Clindamycin and Rifampicin;
Methicillin and Kanamycin.

Local treatment of hidradenitis with antibiotics

Hidradenitis is a purulent inflammation of the apocrine sweat glands. The cause of the disease is most often staphylococci, less often streptococci, Escherichia coli and Pseudomonas aeruginosa, Proteus.

Hydradenitis is equally common in men and women. The disease occurs from the period of puberty, in old age it practically does not occur due to the extinction of the activity of the sweat glands.

Rice. 1. Abscesses under the arm during the disease have a conical shape (popularly called "bitch's udder").

Rice. 2. In the photo, hydradenitis in women.

Rice. 3. Hydradenitis in the perineum and around the anus occurs more often in men.

Briefly about sweat glands

There are two types of sweat glands on the human body - eccrine and apocrine. Eccrine sweat glands are located in the deep layers of the skin over the entire surface of the body, except for the glans penis, foreskin and areas of the red border of the lips. In the region of the palms and soles, the glands are located in the subcutaneous adipose tissue. Eccrine sweat glands are involved in thermoregulation of the body.

Apocrine sweat glands are located in the armpits, genitals, perineum, around the anus and the pigmented area around the nipples. Apocrine sweat glands are not involved in thermoregulation, but are activated during stress. The smell of sweat and its viscosity depends on the degree of destruction of secretory cells. Apocrine sweat glands do not function in children, and in the elderly their function is sharply weakened.

Rice. 4. The secretory glomerulus and the narrow excretory duct are the main structures of the sweat glands.

The perineum in men and the armpits in women are frequent localizations of hidradenitis.

How does hydradenitis develop?

The cause of the disease are golden and white staphylococci.

When penetrating into the excretory ducts of the sweat glands, bacteria begin to multiply.
The duct of the sweat gland is blocked by a corneal plug.
The produced secret, which has no outlet to the outside, stretches the gland.
The accumulated secret is a good breeding ground for bacteria.
The sweat gland becomes inflamed and the duct ruptures.
The infection spreads to surrounding tissues. Fistulous passages are formed.

Rice. 5. In the photo, hydradenitis is under the arm.

Causes of hydradenitis

Contributes to the development of the disease:

increased sweating,
non-compliance with the rules of personal hygiene,
injuries that occur after shaving, scuffs that occur when wearing uncomfortable clothes,
lipid (fat) metabolism disorders,
dysfunction of the gonads,
the use of large amounts of carbohydrates and diabetes create favorable conditions for the development of infection (carbohydrates are a good breeding ground for pyogenic microbes);
malnutrition (insufficient amount of proteins, fats, carbohydrates, vitamins and microelements);
severe somatic pathology, which leads to exhaustion of the body,
contributes to the disease stay in a hot climate and high humidity.

Rice. 6. In the photo, the consequences of hydradenitis under the arm. Multiple scars are visible after the healing of the fistulous passages.

Signs and symptoms of hidradenitis

With the formation of an inflammatory infiltrate in the early stages of the development of the disease, the patient is disturbed by periodic pain. Often several infiltrates are formed, which merge and form one acutely inflammatory, sharply painful infiltrate, which occupies the entire axillary fossa. During this period, the patient may be disturbed by weakness and malaise, sometimes the body temperature rises. The skin over the infiltrate acquires a bluish-pink color. Infiltrates range in size from 0.5 cm to 3 cm. Pain and the appearance of armpit infiltrates are the main symptoms of the disease.
Inflammatory infiltrates either resolve or tissue suppuration (abscess or abscesses) is formed. Abscesses with hydradenitis have a conical shape (popularly called "bitch's udder").
When opening the abscess, thick pus is released. A necrotic core, as with boils and carbuncles, is not formed.

At the sites of fistulous passages, ugly, retracted scars are formed. The duration of the disease is about 2 weeks. Often there is a lesion of the sweat glands of both axillary fossae. Hidradenitis can acquire a chronic relapsing course. People with obesity, diabetes mellitus, impaired function of the gonads, myxedema and reduced immunity are susceptible to the disease. Hydradenitis in them is long-term and has a relapsing course. During periods of exacerbation, the symptoms of the disease are pronounced. At the same time, you can see several foci of inflammation at different stages of their development.

Rice. 7. In the photo, hydradenitis in women.

Complications of the disease

Complications of the disease are:

Inflammation of the lymphatic vessels and lymph nodes.
On the side of hidradenitis, sometimes lymphedema develops - swelling of the soft tissues of the upper limb on the side of hidradenitis.
With the spread of inflammation to the subcutaneous tissue, phlegmon develops.

Rice. 8. In the photo, the consequences of hydradenitis under the arm are hypertrophic and keloid scars.

Rice. 9. At the site of inflammation of the sweat glands under the arm, ugly, retracted scars often form.

Rice. 10. In the photo, inflammation of the lymphatic vessels, as a result of a boil, carbuncle, abscess or hydradenitis.

Differential Diagnosis

To prescribe adequate treatment for hidradenitis, a method should be used differential diagnosis with furuncle, carbuncle, lymphadenitis and felinosis on early stages disease development, and venereal lymphogranuloma, donovaz, scrofuloderma and actinomycosis in later stages of the disease.

Rice. 11. The photo shows an enlarged lymph node in the armpit (left) and a boil (right).

Diagnosis of hidradenitis

The diagnosis of hidradenitis does not cause difficulties. Bright clinical picture and identification of the pathogen in the culture of pus confirm the diagnosis.

Treatment of hidradenitis

Treatment of hidradenitis should be strictly individual. At the stage of infiltration, it is enough symptomatic therapy. At the stage of abscess formation, surgical treatment is used. Antibiotics and means of pathogenetic therapy accelerate recovery. Treatment of a recurrent (chronic) form of hidradenitis includes the use of specific and non-specific agents that increase the body's defenses.

Treatment of hidradenitis at the stage of infiltration

The hair in the armpit is shaved off.
The skin is treated twice a day with a solution 70% ethyl alcohol.

Aniline dyes are used: fucorcin solution (Castellani liquid), brilliant green solution (brilliant green).

Keratoplastic agents are used. Preparations of this group have the property of drying tissues. Taking away water, they help to slow down the processes of fermentation and putrefaction in deep inflammatory infiltrates. Application Shown 20% Ichthyol ointment or pure Ichthyola. An “ichthyol cake” is applied to the affected surface twice a day (the applied ointment is covered with a thin layer of cotton wool).
Acceleration of the resolution of the inflammatory infiltrate is achieved by introducing Triamcinolone glucocorticoid at a dose of 3-5 mg / ml into the lesion and injecting with antibiotics.
During the ripening period of the boil, physiotherapy is indicated (UHF therapy, dry heat).

Rice. 12. In the photo, the consequences of hydradenitis in the groin.

Treatment of hidradenitis at the abscess stage

aim surgical treatment hidradenitis at the abscess stage is the opening of the abscess and ensuring a good outflow of purulent-inflammatory exudate. After opening, the abscess is washed with an antiseptic solution and drained. Drainage ensures unimpeded discharge of pus. In case of difficulty in rejection of purulent-necrotic masses good effect is achieved using: 1% trypsin solution, chymopsin or chymotrypsin with novocaine or isotonic saline sodium chloride. Enzymes break down peptide bonds in protein molecules and their decay products, thereby accelerating the cleansing of purulent wounds.

With widespread chronic process it may be necessary to excise the entire affected skin up to the fascia, followed by skin graft transplantation.

Rice. 13. Accelerating the resolution of the inflammatory infiltrate is achieved by introducing Triamcinolone glucocorticoid at a dose of 3-5 mg / ml into the lesion and injecting with antibiotics.

Use of antibiotics

Antibiotics in the treatment of hidradenitis speed up recovery. Recommended to use:

Antibiotics of the penicillin group ( Cloxacillin).
B-lactam antibiotics ( Dicloxacillin, Amoxicillin-clavulanate).
Macrolides ( Azithromycin, Clarithromycin, Josamycin, Bilprafen, Klacid).
Tetracyclines ( Unidox-solutab, Doxycycline hydrochloride, Vibramycin).
Cephalosporins ( Zinnat, Cephalosporin).
Other antibiotics (Lincomycin, Azithromycin, Clindamycin, Rifampin).

In the treatment of strains of Staphylococcus aureus resistant to methicillin, the use of minomycin, trimethoprim/sulfamethoxazole, Ciprofloxacin or Vancomycin.

Immunotherapy

Some individuals have a steady progression of the disease. For specific treatment recurrent hidradenitis, the means used in the treatment are used. They are represented by anti-staphylococcal immunoglobulin, anti-staphylococcal plasma, staphylococcal toxoid and.

In addition to specific methods of treatment, autohemotherapy, the introduction of protein blood substitutes, pyrogenal, prodigiosan, methyluracil and splenin are indicated. Vitamin therapy and the use of immunomodulators are shown.

Hidradenitis is a purulent inflammation of the apocrine sweat glands, which is caused by the penetration of a staphylococcal infection along the path of the hair follicle (see photo).

Hydradenitis can be observed in the armpits, around the anus, on the scrotum, near the labia and navel, i.e. wherever there is hair.

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Hydradenitis - what is it?

In the people, hydradenitis is called "bitch's udder" for its resemblance to the chest of a dog. In children and the elderly, this disease is not observed. This is due to the fact that the apocrine glands begin to function actively only after the puberty period, and by the age of 50-55 their activity is declining.

Women suffer from the appearance of hydradenitis more often than men. Especially the risk increases during the peak of puberty and menopause against the background of frequent shaving of the armpits.

It is quite simple to determine purulent hydradenitis, because it has several characteristic features. In diameter, the inflammation exceeds 1.5 cm, visually resembles a boil.

A feature of hidradenitis is the absence of a necrotic rod. The pathological focus protrudes noticeably above the surface of the skin, and the entire convex surface is painted bright red. There is swelling and pain around the inflamed area.

Hydradenitis under the armpit and in the inguinal zone, photo

Purulent inflammation of the apocrine sweat glands in 98% of cases is caused by a bacterium such as Staphylococcus aureus. Minor damage is enough to get the pathogen under the skin. It is possible to injure the epidermis during shaving, depilation, epilation.

The use of deodorants that irritate and dry out the skin, thereby contributing to the appearance of microcracks, has a detrimental effect.

Hydradenitis under the arm

The risk of infection of the apocrine gland increases in people suffering from excessive sweating. Wet substance, which is constantly on the skin, reduces its barrier function. Pathogenic microflora easily enters lymphatic ducts or the mouth of the hair follicle, and an inflammatory process develops.

Insufficient hygiene also provokes hydradenitis under the arm. The reasons may lie in violations of the endocrine glands: diabetes mellitus, obesity, hormonal imbalance.

The catalyst for the appearance of hydradenitis is a decrease in immunity and a violation of the acidity of sweat - alkalization.

Hydradenitis in the groin

Hydradenitis in the groin occurs less frequently, but in women and men reproductive age it still happens. This is due to non-compliance hygiene rules during intercourse.

Many people immediately fear that this is a sexually transmitted disease. But if shaving or epilation was carried out immediately before close contact, most likely, we are talking about hydradenitis.

The inflammatory process can go to the armpits and genitals, if the body already has purulent foci. In this case, hydradenitis will have a slightly different nature. For this reason, ulcers in any area cannot be brought to a chronic state.

Symptoms of hydradenitis - features

At the stage of infiltration (initial development), you can notice the appearance of small nodules, dense to the touch. Hydradenitis under the arm or in inguinal region, which is out of sight, will give itself out with unpleasant symptoms: itching, soreness when pressed.

Immediately after the appearance of the nodule, it will rapidly increase in size and acquire a pear-shaped shape. In size, the inflammatory focus reaches 1.5 - 3 cm.

The hydradenitis node is tightly soldered to skin, which turn red-violet in the convex region. As inflammation develops, the nodules merge with each other. Painful sensations appear not only when touched, but also at rest.

The process of maturation of hydradenitis is necessarily accompanied by:

General malaise;
Rapid fatigue;
Painful itchy sensations around the inflammation;
An increase in body temperature.

Hidradenitis in the groin, the symptoms of which are already unpleasant, will deliver severe pain while walking. Such manifestations knock a person out of the daily schedule for several days, until the abscess matures completely.

After maturation, the central zone of the node becomes soft. After 1-2 days, hidradenitis may open spontaneously. Quite a lot of purulent masses with a small amount of blood substances will stand out from the inflamed area.

Blood enters the node due to damage to the vessels during its rapid growth. Bleeding with hydradenitis never happens - it is always the release of blood in a small amount.

After the release of pus, a person feels relieved: the temperature drops and strength returns. The knot disappears, but an ulcer appears in its place. After a few days, it tightens, and a scar appears on the skin.

Often the scar will be sunken in for a while. Then, as new connective tissue is formed, the scar area is leveled.

Hydradenitis can recur and transform into chronic illness. Spontaneous opening of the node may not occur at all. In this case, the patient's condition will worsen, and he will need urgent health care in the form of emergency surgery.

Hidradenitis treatment - drugs and antibiotics

The success of therapy largely depends on the stage at which the patient detects a node in the inguinal zone or hidradenitis under the arm. Treatment of hidradenitis must begin from the moment of the first seals under the skin. For the convenience of manipulation in the affected area, hair is cut off (it is forbidden to shave, because this can aggravate the course of the purulent process).

The node and its surrounding area are treated with an antiseptic, which will reduce pain(in this case, it is necessary to take into account the possibility of an allergy to a particular substance):

Iodine 5%;
Salicylic acid 2%;
Brilliant green 3%;
Ethyl alcohol 96%.

The larger the affected area, the more the node will hurt. To relieve discomfort, an abscess larger than 2 cm is cut off with 1% novocaine with the addition of an injectable vasoconstrictor. The latter reduces the diameter of the vessel and thereby prolongs the action of the anesthetic.

In the treatment of hidradenitis, fatty-based ointments and gels are prohibited - they can provoke the spread of suppuration. For the same reason, the use of compresses is prohibited, only dry heat is allowed. The best option is the imposition of alcohol drying bandages.

Alcohol-free warming can be done:

Iron-heated natural cloth (application method);
The use of a blue lamp for 5-7 minutes (the distance to the node is at least 20 cm);
Ultraviolet radiation (open sun) no more than 30 minutes.

When is surgery indicated?

If hidradenitis does not open on its own, surgical intervention is necessary. Most likely, it will not be possible to manage with local puncture (piercing) and drainage, because there are multiple foci of suppuration.

The opening of hydradenitis is performed full cut. First, the pus is removed, and then the inflamed subcutaneous fatty tissue is cut out.

The wound after surgery is quite voluminous. It is strictly forbidden to close it with bandages - constant treatments with antiseptic agents are necessary, as well as air access (for better regeneration). After the inflammation goes away, granulation of the wound will occur.

After the granulation stage, a second operation is necessary if the tissue defect is very large. During it, the subcutaneous adipose tissue and the skin itself are removed. Next, the patient needs autodermoplasty - moving tissue sections of the operated person to hide cosmetic defects.

Otherwise, a rough scar will remain on the skin. Hydradenitis in the groin is especially unpleasant - treatment in women and men by the radical method should be done with extreme caution. Such localization can affect the health of the reproductive organs if there is a deep spread of the pathological process.

After surgery physiotherapy may be prescribed:

Laser;
magnetic therapy;
Localized UV therapy;
Infrared radiation;
ultrasound therapy;
Electrophoresis with unithiol, dianin, codeine;
X-ray exposure - removes the sweat glands, therefore it is used only in case of constant recurrence of inflammation.

Some of these procedures can be prescribed during the period of infiltration. In some cases, they help to avoid surgery.

The patient must follow a diet aimed at restoring the proper functioning of the glands of the body. At the same time, the function of such a diet is to strengthen the immune barrier. Any sweets, alcohol, spicy food and seasonings, strong coffee are prohibited. At the same time, nuts (walnuts and almonds), citrus fruits, apples, carrots, red and black berries, dried fruits, honey should appear on the table.

Ginseng, aloe, wild rose, plantain have healing properties that restore immunity. Decoctions of them must be drunk instead of tea or added to tea leaves.

Antibiotics

Treatment of hidradenitis should be carried out not only outside, but also inside the body. Antibiotics (erythromycin, doxycycline) can significantly improve the patient's condition. These drugs can be used at all stages of treatment. Antiseptic agents are most effective at initial suppuration (before relapses).

If a relapse occurs, an immunogram is needed (especially for multiple relapses). According to the study, immunostimulants are prescribed.

The task of therapy is to completely destroy staphylococcal bacteria. They fight the pathogen by injection: gamma globulin, the vaccine against Staphylococcus aureus.

In parallel with the treatment of the hydradenitis node, inflammation is prevented in other apocrine sweat glands. staph infection can spread to any part of the body, but the patient can protect the surrounding glands.

Needs to be processed antiseptic solution(brilliant green, iodine, ethyl and boric alcohol) not only the node itself, but also the space around. The area to be treated is limited intimate areas»: armpits, perineum, navel. In other locations, the appearance of hydradenitis is almost impossible.

Before taking a shower, bath or other water procedures, a bandage must be applied to hydradenitis. The patch will prevent the spread of infection throughout the body.

Complications of hidradenitis

Hidradenitis should in no case be confused with a classic pimple, abscess or boil. Untimely or incompetent treatment can seriously affect the patient's health.

Axillary hidradenitis transforms into a large abscess if surgery or drainage was not performed correctly. The culprit is inflamed subcutaneous fat. Abscess strikes soft tissues and this greatly complicates the treatment.

Hidradenitis can become putrefactive phlegmon if surgery is not performed in two stages. The second autopsy is necessary, because even at the stage of an ulcerative wound, the node recurs.

Another risk is the development of chronic lymphadenitis. This complication is possible if the staphylococcal bacterium entered the body through the lymphatic channel. Refusal to treat hidradenitis threatens the patient with sepsis and endangers his life.

Hydradenitis: which doctor should I contact?

Any skin diseases bring a person to a dermatologist, it is this doctor who should conduct an initial examination. Further, the patient can be referred to doctors who treat the cause of inflammation:

Immunologist;
Endocrinologist;
Infectionist.

In addition, during the treatment process, you will need the help of a nutritionist or an allergist.

Trophic ulcers on the legs - stages, photos, treatment in ...

The disease begins to develop, when bacteria, mainly staphylococci, enter the ducts of these special sweat glands, which develop and function with particular force in adolescence. More often, hydradenitis occurs in people who do not follow the rules of personal hygiene, who suffer from excessive sweating (), dermatological and endocrine diseases. It develops in the locations of the apocrine glands: in the armpits, on the labia majora, scrotum, around the anus or nipples. Depending on the stage of the disease (), the tactics of treatment may be different, but antibiotics for hydradenitis are required.

Hydradenitis treatment with antibiotics

Important! Self-treatment this disease unacceptable and can be dangerous. Prescribe drugs for treatment should be a doctor who can choose the most effective remedy against pathogen inflammatory process, will take into account possible contraindications and select the correct dosage.

With hydradenitis, various antibiotics are taken.

Treatment of hidradenitis with antibiotics is carried out for 7-10 days. They can be administered orally in tablet form or as intramuscular injections. It all depends on the complexity of the course of the disease.

Various antibiotics are used for bough udders. They may differ in the mechanism of therapeutic action.

The following groups of drugs are most effective:

tetracyclines - prevent further reproduction of staphylococci and the development of other diseases (, etc.), acting directly on bacteria;
macrolides - are well absorbed and quickly reach the goal, are easily tolerated by the human body, stop the growth and reproduction of pathogenic microorganisms, and healthy cells protect against the spread of infection and infection;
cephalosporins - destructive effect on cell walls pathogenic bacteria;
lincosamides - cause rapid death of bacteria, are used only externally, in the form of lotions.

Effective treatment requires a complex effect, so other drugs are also used: immunostimulants, corticosteroids and antihistamines.

Treatment at the initial stage

At first, hidradenitis is a subcutaneous thickening that causes pain to the patient. If adequate treatment is carried out within 2-3 days after its appearance, then the node may resolve. To do this, you need to properly treat the skin at the site of inflammation:

hair should be removed with small scissors;
2-3 times a day, the skin is wiped to relieve inflammation and disinfect with an alcohol tincture of calendula, salicylic or boric acid;
for 20 minutes several times a day, you need to apply a cotton-gauze swab soaked in ioddicerin;
to relieve inflammation, you can apply for several hours (2-3 times a day) a drying bandage soaked in an antiseptic: chlorophyllipt; dioxidine, etc.

Dry heat is also used (if pus has not yet begun to accumulate) and various physiotherapy procedures. An antibiotic for hydradenitis is not used at this stage, but if after 3 days there is no positive dynamics, then you need to tell the doctor about this and change the treatment tactics.

Further treatment

Important! At the stage of infiltration, when pus has not yet begun to form, conservative treatment antibiotics. Bough udder in many people proceeds with complications and relapses. Rarely, treatment without surgery brings results. If in this way the process of pus formation is delayed, then recovery does not come soon.

Treatment of hidradenitis is also carried out surgically.

Often, without surgery, recovery is impossible. Under local anesthesia the doctor makes a deep incision, sanitizes the inflamed cavity and installs drainage, when the wound heals, the second stage of the operation is performed - autodermoplasty. Antibiotics for a bough udder in the case of surgical treatment are prescribed mandatory. Recovery can occur 2 weeks after the start of treatment.

Many diseases are successfully amenable to therapeutic effects using folk remedies. It is not safe to treat bitch udders on your own according to grandmother's recipes. Only if the attending physician approves these drugs and prescribes them in combination with other medications, they can be used. In the treatment of a disease such as hidradenitis, antibiotics have been and remain the main drug, without which recovery is delayed. What antibiotics to drink with hydradenitis, in what dosage, the doctor should determine.

People with excessive sweating and disruptions at work endocrine system, as well as those who have already had cases of inflammation of the apocrine glands, should be especially careful to observe preventive measures. These include reducing the risk of injury to the skin where these glands are located, practicing good personal hygiene, wearing comfortable clothing, and using natural cosmetics for skin care. If you suspect the development of hidradenitis, do not delay, but immediately consult a doctor.