{"id":80463,"date":"2025-08-24T16:25:11","date_gmt":"2025-08-24T07:25:11","guid":{"rendered":"http:\/\/ic-clinic-ueno.com\/hidradenitis-suppurativa\/"},"modified":"2026-07-06T19:32:27","modified_gmt":"2026-07-06T10:32:27","slug":"hidradenitis-suppurativa","status":"publish","type":"page","link":"https:\/\/ic-clinic-ueno.com\/en\/treatment\/hidradenitis-suppurativa\/","title":{"rendered":"Hidradenitis Suppurativa (Chronic Pyoderma) Treatment | IC Clinic Ueno"},"content":{"rendered":"\n<div class=\"wp-block-group has-border-color has-fff-5-f-5-background-color has-background is-layout-constrained wp-container-core-group-is-layout-93621183 wp-block-group-is-layout-constrained\" style=\"border-color:#ff6b6b;border-width:3px;border-radius:10px;padding-top:var(--wp--preset--spacing--50);padding-right:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50);padding-left:var(--wp--preset--spacing--50)\">\n<p class=\"has-medium-font-size wp-block-paragraph\">\ud83d\udca1 <strong>What You Will Learn From This Article<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u2728 <mark>Specific symptoms of hidradenitis suppurativa and how to identify them<\/mark><\/li>\n\n\n\n<li>\ud83d\udd2c Causes and risk factors (smoking and obesity require particular attention!)<\/li>\n\n\n\n<li>\ud83d\udc8a <mark>Two treatment approaches (surgery and medication)<\/mark><\/li>\n\n\n\n<li>\ud83d\udee1\ufe0f Prevention measures you can start today<\/li>\n<\/ul>\n\n\n\n<p class=\"has-text-align-center has-small-font-size wp-block-paragraph\">\u26a0\ufe0f <span style=\"color: #ff0000;\"><strong>If left untreated, symptoms may worsen and scarring may result<\/strong><\/span><br>Early diagnosis and treatment are important<\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-20959078 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-ff-4757-background-color has-background wp-element-button\" href=\"https:\/\/ic-clinic.com\/reservation\/ueno\/\" style=\"border-radius:50px\">\ud83d\udcde Book a Consultation Now<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">\u201c<mark>I am experiencing pain and swelling from a skin lesion.<\/mark>\u201c<br>\u201c<mark>I want to get treatment, but I don\u2019t know which medical specialty to visit.<\/mark>\u201c<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83c\udfe5 Are you troubled by <mark>painful, swollen, red bumps<\/mark> on your body and unsure how to address them?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u26a0\ufe0f If hidradenitis suppurativa is the cause, the condition can worsen over time\u2014<span style=\"color: #ff0000;\"><mark>pus may develop and symptoms may spread<\/mark><\/span>\u2014so <mark>prompt attention is important<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2705 With hidradenitis suppurativa, <mark>surgical removal of the affected tissue may be an option<\/mark>. Medical treatment is also available, so we encourage you to consider consulting a clinic.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udcd6 This page explains <mark>the causes, prevention, and clinical treatment options for hidradenitis suppurativa<\/mark>. We hope it helps you understand how to manage the condition.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-0\">\ud83d\udd0d What Is Hidradenitis Suppurativa? | A Condition Causing Lumps, Swelling, and Pus<\/h2>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_renewal\/shared\/img\/med\/hidradenitis-suppurativa\/pic01.jpg\" alt=\"\"><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Hidradenitis suppurativa is a skin condition characterized by <mark>recurring, painful, red, swollen bumps<\/mark> [1,6,8].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Formally known as \u201c<mark>hidradenitis suppurativa (HS)<\/mark>,\u201d it is classified as a <mark>chronic inflammatory skin disease<\/mark> within the group of follicular occlusion disorders [8,20].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udca1 It tends to occur in areas rich in apocrine sweat glands, and the <mark>Hurley staging system is internationally used as the standard method for assessing disease severity<\/mark> [5,8].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The specific symptoms of hidradenitis suppurativa are as follows.<\/p>\n\n\n<div id=\"id-3fc2f05f-a3d8-43a9-b507-1573f84dfd09\">\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><th>Symptom<\/th><th>Description<\/th><\/tr><tr><th>\ud83d\udca2 Nodules<\/th><td>Firm lumps or bumps under the skin that <mark>may become red and swollen over time<\/mark><\/td><\/tr><tr><th>\ud83d\udca7 Abscesses<\/th><td><mark>Pus-filled cavities that form beneath the skin<\/mark><\/td><\/tr><tr><th>\ud83d\udd34 Sinus tracts (fistulas)<\/th><td><span style=\"color: #ff0000;\">Tunnel-like passages through which pus drains, often accompanied by pain<\/span><\/td><\/tr><tr><th>\u26a0\ufe0f Scarring<\/th><td>Thick, hardened scar tissue that forms as a result of repeated flare-ups, <mark>leaving visible scars<\/mark><\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">(Reference: <a href=\"https:\/\/a-connect.abbvie.co.jp\/-\/media\/assets\/pdf\/products\/humira\/ordering\/JP-HUMD-180080-2,-d-,0.ashx\" target=\"_blank\" rel=\"noreferrer noopener\">Do You Know About Hidradenitis Suppurativa?<\/a>)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udccd The condition commonly develops under the breasts, on the buttocks, in the groin, and in the armpits, and most often affects people in their 20s to 40s [7,14,23]. Prevalence is estimated at 0.05\u20134% in Western countries and approximately 0.05\u20130.1% in Japan. It has been reported that <span style=\"color: #ff0000;\"><mark>women are affected approximately 2\u20133 times more often than men<\/mark><\/span> [7,14]. <mark>The average time from symptom onset to diagnosis is approximately 7\u201310 years<\/mark>, and delayed diagnosis is recognized as a global concern [27].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u26a0\ufe0f If left untreated, hidradenitis suppurativa can lead to <span style=\"color: #ff0000;\"><mark>pus accumulation<\/mark><\/span>, and as the condition progresses, <span style=\"color: #ff0000;\"><mark>lesions beneath the skin may become interconnected<\/mark><\/span>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udea8 <span style=\"color: #ff0000;\"><mark>As symptoms worsen, they can cause significant swelling and pain, making early treatment important.<\/mark><\/span> Delayed management may also result in scarring (known as cicatrices) in the affected areas.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-1\">\ud83e\uddec Causes of Hidradenitis Suppurativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Clogged hair follicles are thought to play a role in the development of hidradenitis suppurativa [9,17,28]. At the molecular level, the overproduction of inflammatory cytokines such as TNF-\u03b1, IL-1\u03b2, and IL-17, along with impaired skin barrier function, is considered central to the pathophysiology [18,28]. In addition, genetic mutations in genes such as NCSTN, PSEN1, and PSENH have been identified in familial cases, suggesting that genetic predisposition is also an important contributing factor [8,28].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udca1 Follicular blockage can occur when <mark>dead skin cells are not shed smoothly due to aging or disruption of the skin cell turnover cycle<\/mark>. <mark>Hormonal changes can also contribute to clogged follicles<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2699\ufe0f When pressure or friction is applied to a blocked follicle, <mark>the follicular wall can rupture, allowing its contents to leak out and trigger inflammation<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udeac In addition, <span style=\"color: #ff0000;\"><mark>smoking and obesity are also considered factors that may increase the risk of developing hidradenitis suppurativa<\/mark><\/span> [14,22,23]. Large-scale epidemiological studies have shown that <span style=\"color: #ff0000;\">the risk in smokers is approximately 3\u20134 times higher than in non-smokers, and approximately 2\u20133 times higher in individuals with a BMI of 30 or above<\/span> [14,22]. Other reported risk factors include mechanical friction, hormonal fluctuations, stress, and certain dietary factors (such as dairy products and high-glycemic foods) [14,23].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67\u200d\ud83d\udc66 A family history of the condition has also been noted as a potential trigger, although the precise causes have not been fully established.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-2\">\ud83d\udcca Severity Assessment of Hidradenitis Suppurativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The <mark>Hurley staging system<\/mark> is used internationally to assess the severity of hidradenitis suppurativa [5,6].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udccc <mark>Stage I: Abscess formation without sinus tracts or scarring<\/mark><br>\ud83d\udccc <mark>Stage II: Recurrent abscesses with single or multiple sinus tracts and scarring<\/mark><br>\ud83d\udccc <span style=\"color: #ff0000;\"><mark>Stage III: Diffuse involvement with multiple interconnected sinus tracts, abscesses, and extensive scarring with broad areas of induration<\/mark><\/span><br>The condition is classified into these three stages [5].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-3\">\ud83d\udd2c Conditions Similar to Hidradenitis Suppurativa | Differences and How to Tell Them Apart<\/h2>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_renewal\/shared\/img\/med\/hidradenitis-suppurativa\/pic02.jpg\" alt=\"\"><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Conditions that resemble hidradenitis suppurativa include <mark>epidermoid cysts (atheroma) and folliculitis<\/mark>.<\/p>\n\n\n<div id=\"id-6c4b6fb5-44a6-4a67-82ce-b9d9f9695462\">\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><th>Condition<\/th><th>Description<\/th><\/tr><tr><th>\ud83d\udd35 Epidermoid Cyst (Atheroma)<\/th><td>A benign cyst that forms when <mark>waste products such as sebum accumulate beneath the skin<\/mark><\/td><\/tr><tr><th>\ud83d\udfe1 Folliculitis<\/th><td>Inflammation of the hair follicle caused by <mark>bacterial entry into the follicle<\/mark><\/td><\/tr><tr><th>\ud83d\udd34 Hidradenitis Suppurativa<\/th><td>Inflammation caused by <mark>the rupture of a hair follicle and leakage of its contents<\/mark><\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">\u26a0\ufe0f Attempting treatment based on an incorrect diagnosis <span style=\"color: #ff0000;\"><mark>may result in the condition failing to improve or worsening<\/mark><\/span>. Below, we outline how hidradenitis suppurativa differs from similar conditions and how each should be approached.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"i-4\">\ud83d\udd35 Epidermoid Cyst (Atheroma)<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">An epidermoid cyst is <mark>a benign growth that forms when waste products such as dead skin cells and sebum, which would normally be shed, accumulate inside a pocket beneath the skin.<\/mark><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udcc8 Initially, an epidermoid cyst appears as <mark>a small lump<\/mark>, but as waste continues to accumulate inside the sac, it <mark>gradually grows larger<\/mark> over time.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udd0d One distinguishing feature from hidradenitis suppurativa is that <mark>an epidermoid cyst has a small opening (punctum) in the skin over the cyst<\/mark>. Bacteria can enter through this opening, <mark>causing infection<\/mark> and symptoms such as pain and warmth.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udca7 As with the bumps caused by hidradenitis suppurativa, pus may also develop as the condition progresses.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2705 <mark>When identified at an early stage, the condition may be managed with antibiotics<\/mark>, so visiting a clinic as soon as possible is important. For more information on the causes, symptoms, and treatment options for epidermoid cysts, please refer to the following page.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"http:\/\/ic-clinic-ueno.com\/en\/treatment\/atheroma\/\">About Epidermoid Cysts (Atheroma)<\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"i-5\">\ud83d\udfe1 Folliculitis<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Folliculitis is <mark>inflammation of the hair follicle<\/mark>\u2014the deeper part of the pore that surrounds the hair root.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83e\udda0 It is caused by bacteria entering through a break in the skin surface. Symptoms of folliculitis include <mark>redness and pus-filled spots<\/mark> around the affected follicles.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udccd Although hidradenitis suppurativa and folliculitis share similar symptoms, <mark>they differ in the areas affected and their underlying causes<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Folliculitis tends to occur on <mark>the back of the neck, the thighs, and around the genital area<\/mark>. Hidradenitis suppurativa, on the other hand, more commonly develops <mark>under the breasts, on the buttocks, in the groin, and in the armpits<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83e\uddfc For folliculitis, <mark>keeping the skin clean<\/mark> is key both for prevention and management. Mild cases may <mark>resolve within approximately one week with proper cleansing of the affected area<\/mark>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-6\">\ud83d\udee1\ufe0f How to Help Prevent Hidradenitis Suppurativa<\/h2>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_renewal\/shared\/img\/med\/hidradenitis-suppurativa\/pic03.jpg\" alt=\"\"><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">To help reduce the risk of developing hidradenitis suppurativa, <span style=\"color: #ff0000;\"><mark>avoiding obesity and smoking is considered important<\/mark><\/span>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2696\ufe0f Obesity <mark>increases pressure on the skin and promotes friction from clothing<\/mark>, which may raise the likelihood of developing hidradenitis suppurativa. <mark>Reviewing your diet and exercise habits to help maintain a healthy weight<\/mark> is worthwhile.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udc8a Our clinic offers treatments such as <mark>GLP-1 therapy to help regulate food intake<\/mark> as part of an approach to weight management. If you are looking for support with obesity, consulting with us about treatment options may be helpful.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For more details on medical weight management, please see the following page.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/ic-clinic.com\/female\/slimming\/\">What Is the Difference Between Aesthetic Slimming and Medical Weight Management? Benefits, Drawbacks, and What to Expect<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udead In addition, <mark>chemical components in cigarettes can promote hardening of the skin<\/mark>, contributing to the development of hidradenitis suppurativa. <mark>Quitting smoking may also help reduce the risk of other health conditions<\/mark>, so reviewing your smoking habits is recommended.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-7\">\ud83d\udc8a How Is Hidradenitis Suppurativa Treated? Two Main Approaches<\/h2>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_renewal\/shared\/img\/med\/hidradenitis-suppurativa\/pic04.png\" alt=\"\"><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The two main treatment approaches for hidradenitis suppurativa are <span style=\"color: #ff0000;\"><mark>medication and surgical removal<\/mark><\/span>. <mark>Surgical excision may offer a more fundamental resolution<\/mark>. The characteristics of each approach are outlined below.<\/p>\n\n\n\n<div class=\"wp-block-group has-border-color has-f-0-f-8-ff-background-color has-background is-layout-constrained wp-container-core-group-is-layout-93621183 wp-block-group-is-layout-constrained\" style=\"border-color:#4a90e2;border-width:3px;border-radius:10px;padding-top:var(--wp--preset--spacing--50);padding-right:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50);padding-left:var(--wp--preset--spacing--50)\">\n<p class=\"has-medium-font-size wp-block-paragraph\">\ud83d\udca1 <strong>How to Choose a Treatment Approach<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The most appropriate treatment will vary depending on the stage of progression and the location of symptoms.<br><mark>A consultation with a specialist can help identify the treatment plan that is right for you<\/mark>.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-20959078 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-4-a-90-e-2-background-color has-background wp-element-button\" href=\"https:\/\/ic-clinic.com\/reservation\/ueno\/\" style=\"border-radius:50px\">\ud83c\udfe5 Consult a Specialist<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"i-8\">\u2702\ufe0f Surgical Removal<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Surgery for hidradenitis suppurativa typically involves wide excision of the affected skin through all layers [10,21,29]. <mark>Surgical treatment is considered the most definitive approach<\/mark>, and <mark>complete removal of the affected tissue may help minimize the likelihood of recurrence<\/mark> [21,29]. Surgical options include wide excision, limited excision, CO2 laser excision, and skin grafting, with the choice depending on the extent and location of the lesions [21,29].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83c\udfe5 When the condition has spread over a wide area, <mark>skin flap procedures or skin grafting may be required<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udccc In such cases, <mark>a referral to a university hospital or general hospital will be arranged<\/mark>. Our clinic is able to address <mark>cases involving partial skin removal<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u26a0\ufe0f When a long period has passed since onset and inflammation has spread beneath the skin, <mark>incomplete removal may lead to recurrence<\/mark>. In rare cases, <span style=\"color: #ff0000;\"><mark>skin cancer can develop at the site of hidradenitis suppurativa, making thorough excision of the affected area important.<\/mark><\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2705 <mark>By removing tissue with an adequate margin beyond the visible affected area, we aim for complete removal.<\/mark><\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"i-9\">\ud83d\udc8a Medication<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">When surgical excision does not achieve the desired results or symptoms do not improve sufficiently, <mark>medical treatment<\/mark> may also be considered.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udc8a <mark>Oral medications, topical treatments, and injectable therapies<\/mark> are among the available options.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example, adalimumab (Humira\u00ae) has been shown to <mark>reduce nodules and lesions associated with the condition<\/mark> [11]. Adalimumab is an <mark>anti-TNF-\u03b1 antibody<\/mark> whose efficacy and safety in moderate-to-severe hidradenitis suppurativa were demonstrated in Phase III clinical trials (PIONEER I\/II) [11]. Other biologics, including infliximab, ustekinumab, and secukinumab, are also among the available treatment options [4,12].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2728 Medical treatment can also <mark>help reduce pain associated with hidradenitis suppurativa<\/mark>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u23f0 However, <mark>it takes approximately three months for the therapeutic effects of Humira to become apparent<\/mark>. Humira is administered by <mark>injection into the abdomen, thigh, or back of the upper arm<\/mark>, allowing the medication to circulate throughout the body.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83c\udfe0 <mark>Self-injection is possible<\/mark>, which has the advantage of reducing the need for frequent clinic visits.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udccc Please note that our clinic does not provide medication-based treatment for this condition. If this is your preference, we will arrange a referral to a general hospital.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-10\">\ud83d\ude14 Impact on Quality of Life (QOL)<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Hidradenitis suppurativa can have a <span style=\"color: #ff0000;\"><mark>serious impact on patients\u2019 quality of life (QOL)<\/mark><\/span> [24,30].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udcca International research has reported that <span style=\"color: #ff0000;\"><mark>approximately 80% of patients experience difficulties in daily life, and approximately 60% report an impact on their ability to work<\/mark><\/span> [24,30].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udcad The <mark>co-occurrence of depression and anxiety disorders is also significantly higher among patients compared to the general population<\/mark>, and psychological support is considered an important component of overall care [24].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-11\">\ud83d\udcc8 Epidemiology and Prevalence of Hidradenitis Suppurativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Hidradenitis suppurativa is a <mark>chronic inflammatory skin condition that is gaining increasing recognition worldwide<\/mark>, with prevalence varying by region [7,14,23].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83c\udf0d Estimates suggest a prevalence of 0.05\u20134% in Western countries and approximately 0.05\u20130.1% in Japan, with <span style=\"color: #ff0000;\"><mark>women affected approximately 2\u20133 times more frequently than men<\/mark><\/span> [7,14].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udc76 Onset most commonly occurs after puberty, with <mark>an average age of onset of approximately 23 years<\/mark> [14]. <mark>Delayed diagnosis is a recognized issue, with international reports indicating an average of 7\u201310 years between symptom onset and confirmed diagnosis<\/mark> [27].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-12\">\ud83d\udd2c Pathophysiology and Molecular Mechanisms of Hidradenitis Suppurativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The pathophysiology of hidradenitis suppurativa involves a <mark>complex inflammatory cascade in which both innate and adaptive immunity play roles<\/mark> [18,28].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83e\uddea Overproduction of inflammatory cytokines including TNF-\u03b1, IL-1\u03b2, IL-17, and IL-23 is a hallmark feature, and these cytokines are considered central to the formation and progression of lesions [18].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83e\uddec <mark>Impaired skin barrier function, hyperkeratosis of the follicular epithelium, and changes in the skin microbiome<\/mark> also contribute to the pathophysiology [28].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67\u200d\ud83d\udc66 In familial cases, mutations in genes associated with the \u03b3-secretase complex\u2014including NCSTN, PSEN1, and PSENH\u2014have been identified [8,28].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-13\">\ud83e\ude7a Diagnostic Criteria and Differential Diagnosis of Hidradenitis Suppurativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Diagnosis of hidradenitis suppurativa is based on <mark>internationally recognized clinical criteria<\/mark> [6,20].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udccb The primary diagnostic criteria require all three of the following to be present:<br>\u2460 <mark>Typical skin lesions (deep, painful nodules)<\/mark><br>\u2461 <mark>Typical anatomical locations (axillae, groin, perianal area, inframammary region)<\/mark><br>\u2462 <mark>A chronic, relapsing course<\/mark><br><span style=\"color: #ff0000;\"><mark>All three criteria must be satisfied<\/mark><\/span> [6].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udd0d Differential diagnoses include Crohn\u2019s disease-associated pyoderma, folliculitis, epidermoid cysts, and cutaneous manifestations of Beh\u00e7et\u2019s disease. Detailed medical history and skin biopsy can be helpful in distinguishing between these conditions [20].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-14\">\ud83d\udcda Treatment Guidelines and Scientific Evidence<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Treatment of hidradenitis suppurativa is guided by the 2020 Clinical Practice Guidelines of the Japanese Dermatological Association [6].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udc8a For mild cases, <mark>topical treatments (topical antibiotics, combination therapy with clindamycin and rifampicin)<\/mark> are recommended, while <mark>systemic treatment (oral antibiotics, biologics)<\/mark> is recommended for moderate-to-severe cases [6].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2728 Among biologics, <mark>the efficacy of adalimumab (an anti-TNF-\u03b1 agent) has been demonstrated in multiple large-scale clinical trials<\/mark>, with <mark>significant improvement noted particularly in patients with Hurley Stage II\u2013III disease<\/mark> [11].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2702\ufe0f <mark>Surgical treatment is considered the definitive therapeutic approach<\/mark>, with <mark>complete excision of the affected tissue offering the potential for long-term remission<\/mark> [21,29].<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"i-15\">\ud83c\udf0f Hidradenitis Suppurativa (HS)<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Internationally, the condition is referred to as <mark>Hidradenitis Suppurativa (HS)<\/mark>, and <mark>active research is being conducted in Western countries<\/mark> [8].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-16\">\u2753 Frequently Asked Questions About Hidradenitis Suppurativa<\/h2>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_renewal\/shared\/img\/med\/hidradenitis-suppurativa\/pic05.jpg\" alt=\"\"><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Below are answers to frequently asked questions about hidradenitis suppurativa. We hope this section helps <mark>address your concerns and puts your mind at ease regarding treatment<\/mark>.<\/p>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1756020132029\"><strong class=\"schema-faq-question\">Q. Can hidradenitis suppurativa resolve on its own?<\/strong> <p class=\"schema-faq-answer\">As a <mark>chronic progressive condition, hidradenitis suppurativa rarely resolves without treatment<\/mark> [8,20]. <span style=\"color: #ff0000;\"><mark>Without appropriate intervention, symptoms may worsen and lead to scarring and functional impairment<\/mark><\/span> [8]. <mark>Starting treatment as early as possible is important<\/mark> [6]. If the underlying contributing factors are addressed, there is a possibility that symptoms may improve without antibiotics.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1756020155552\"><strong class=\"schema-faq-question\">Q. Is hidradenitis suppurativa designated as an intractable disease in Japan?<\/strong> <p class=\"schema-faq-answer\">In Japan, <mark>hidradenitis suppurativa is not designated as a specified intractable disease (shitei nanbyo)<\/mark> [26]. However, <mark>patients with severe cases may be eligible for medical expense assistance programs such as the High-Cost Medical Expense Benefit (K\u014dgaku Ry\u014dy\u014dhi Seido)<\/mark> [26]. In Western countries, it is recognized as a rare disease with established specialized treatment frameworks [8]. (Reference: <a href=\"http:\/\/hifu-iden-nanbyou.com\/news.html\" target=\"_blank\" rel=\"noreferrer noopener\">Ministry of Health, Labour and Welfare Scientific Research Grants<\/a>)<br>\ud83d\udca1 Hidradenitis suppurativa is <mark>not widely known by name<\/mark>. As a result, depending on the specialty consulted, <mark>an accurate diagnosis may not always be reached<\/mark>.<br>\ud83d\udcb0 <mark>While the condition does not qualify for the medical expense subsidies associated with designated intractable diseases, some financial assistance programs are available<\/mark>\u2014for example, <mark>the High-Cost Medical Expense Benefit and supplementary benefit programs that provide reimbursement for out-of-pocket costs<\/mark>.<br>\ud83d\udcde If you have questions about eligibility for these programs, please contact your health insurance association directly.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1756020171620\"><strong class=\"schema-faq-question\">Q. Are there areas of the body where hidradenitis suppurativa is more likely to develop?<\/strong> <p class=\"schema-faq-answer\"><mark>The condition tends to occur in areas rich in apocrine sweat glands<\/mark>, most commonly the <mark>axillae (85%), groin (70%), perianal area (45%), and inframammary region (35%)<\/mark> [15,23]. These locations are thought to be <mark>prone to follicular occlusion due to friction and a moist environment<\/mark> [9,17].<br>\ud83d\udc68 Hidradenitis suppurativa <span style=\"color: #ff0000;\"><mark>tends to develop in the armpits, buttocks, and groin in men, while in women it more commonly appears on the chest, armpits, buttocks, and inner thighs.<\/mark><\/span><br>\u26a0\ufe0f <mark>Because the condition can develop in areas that are difficult to see\u2014such as the armpits or buttocks\u2014it is easy to miss signs of progression.<\/mark><br>\ud83d\udca7 <mark>As the condition advances, pus can accumulate in the swollen, inflamed bumps<\/mark>, and the affected area may gradually expand. In more severe cases, <span style=\"color: #ff0000;\"><mark>lesions beneath the skin may become interconnected, allowing inflammation to spread further<\/mark><\/span>.<\/p> <\/div> <\/div>\n\n\n\n<div class=\"wp-block-group has-border-color has-fff-5-f-5-background-color has-background is-layout-constrained wp-container-core-group-is-layout-93621183 wp-block-group-is-layout-constrained\" style=\"border-color:#ff6b6b;border-width:3px;border-radius:10px;padding-top:var(--wp--preset--spacing--50);padding-right:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50);padding-left:var(--wp--preset--spacing--50)\">\n<p class=\"has-text-align-center has-large-font-size wp-block-paragraph\">\ud83c\udfe5 <strong>For Those Concerned About Hidradenitis Suppurativa<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Early detection and early treatment are important.<br><mark>Please consult a specialist before symptoms worsen.<\/mark><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u2705 <mark>Same-day outpatient surgery available<\/mark><\/li>\n\n\n\n<li>\u2705 <mark>Board-certified plastic surgeon on staff<\/mark><\/li>\n\n\n\n<li>\u2705 <mark>Treatment with careful attention to minimizing discomfort<\/mark><\/li>\n\n\n\n<li>\u2705 <mark>Techniques aimed at minimizing scarring<\/mark><\/li>\n\n\n\n<li>\u2705 <mark>3-minute walk from JR Ueno Station<\/mark><\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-20959078 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-ff-4757-background-color has-background wp-element-button\" href=\"https:\/\/ic-clinic.com\/reservation\/ueno\/\" style=\"border-radius:50px\">\ud83d\udcde Book Now (Available 24 Hours)<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"has-text-align-center has-small-font-size wp-block-paragraph\">\ud83d\udcf1 Reservations by phone are also welcome.<br>TEL: 0120-000-702<\/p>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-17\">\u2728 Five Features of Our Clinic That Patients Appreciate<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_theme\/images\/ic_img\/lp\/atheroma\/img_tokutyo1.png\">\ud83c\udfe5 <mark>Team-Based Care<\/mark><br>Our clinic brings together specialists from multiple disciplines\u2014including plastic surgery, dermatology, and orthopedic surgery\u2014under the leadership of a board-certified plastic surgeon certified by the Japan Society of Plastic and Reconstructive Surgery.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_theme\/images\/ic_img\/lp\/atheroma\/img_tokutyo2.png\">\ud83d\udc8a <mark>Pain Management<\/mark><br>Our specialist physicians select the most appropriate surgical approach from a wide range of options, with the aim of minimizing discomfort throughout treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_theme\/images\/ic_img\/lp\/atheroma\/img_tokutyo3.png\">\u2728 <mark>Minimal Scarring<\/mark><br>We perform surgical excision with careful attention to the surrounding tissue, striving to minimize damage to the skin and achieve a clean result.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_theme\/images\/ic_img\/lp\/lipoma\/img_tokutyo5.png\">\ud83c\udfe0 <mark>Same-Day Surgery Available \u2014 No Hospital Admission Required<\/mark><br>The process from consultation to surgery is smooth and efficient. Same-day, outpatient surgery is available.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><img decoding=\"async\" src=\"https:\/\/ic-clinic.com\/wp-content\/themes\/ic_theme\/images\/ic_img\/lp\/atheroma\/img_tokutyo6.png\">\ud83d\ude83 <mark>Convenient Location<\/mark><br>Our clinics are located just a 3-minute walk from major transport hubs in central Tokyo, including JR Shinjuku South Exit and JR Shibuya Station.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"i-18\">\ud83d\udcad Many patients visit our clinic with concerns like these.<br>Do any of these sound familiar?<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\ud83d\udca2 Experiencing <mark>pain or swelling<\/mark> caused by a skin lesion<\/li>\n\n\n\n<li>\ud83d\udccd Having a lesion <mark>under the breast, on the buttocks, in the groin, or in the armpit<\/mark><\/li>\n\n\n\n<li>\ud83d\udca7 Experiencing pain with <mark>pus draining<\/mark> from a pore<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\ude83 <mark>Our clinics are conveniently located just a 3-minute walk from major transport hubs such as Shinjuku South Exit and Shibuya Station<\/mark>, so if you are considering treatment for hidradenitis suppurativa, please do not hesitate to reach out to us.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"i-19\">\ud83d\udcda References<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Japanese Dermatological Association, ed. Dermatology, 11th Edition. Bunkodo, 2018.<\/li>\n\n\n\n<li>Zouboulia-Vafiadis I, Prens EP, Kanni T, et al. Inflamed hidradenitis suppurativa lesions: the role of bacteria and antimicrobial treatment. Antibiotics. 2020;9(11):826.<\/li>\n\n\n\n<li>Zouboulia-Vafiadis I, Alexiou GA, Karagkiozi E, et al. Hidradenitis suppurativa: a systematic review of therapeutic interventions based on an assessment of quality of evidence. Br J Dermatol. 2021;184(5):802-818.<\/li>\n\n\n\n<li>Gulliver WP, Jemec GB, Baker KA. Experience with ustekinumab for the treatment of moderate to severe hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2012;26(7):911-914.<\/li>\n\n\n\n<li>Hurley HJ. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus: surgical approach. In: Roenigk RK, Roenigk HH Jr, editors. Dermatologic Surgery. New York: Marcel Dekker; 1989. p. 623-645.<\/li>\n\n\n\n<li>Japanese Dermatological Association. Clinical Practice Guidelines for Hidradenitis Suppurativa, 2020 Edition. 2020.<\/li>\n\n\n\n<li>Jemec GB, Heidenheim M, Nielsen NH. The prevalence of hidradenitis suppurativa and its potential precursor lesions. J Am Acad Dermatol. 1996;35(2 Pt 1):191-194.<\/li>\n\n\n\n<li>Sabat R, Jemec GB, Matusiak \u0141, et al. Hidradenitis suppurativa. Nat Rev Dis Primers. 2020;6(1):18.<\/li>\n\n\n\n<li>Prens E, Deckers I. Pathophysiology of hidradenitis suppurativa: An update. J Am Acad Dermatol. 2015;73(5 Suppl 1):S8-11.<\/li>\n\n\n\n<li>Japan Society of Plastic and Reconstructive Surgery, ed. Plastic Surgery, 4th Edition. Kokuseidodo, 2017.<\/li>\n\n\n\n<li>Kimball AB, Kerdel F, Adams D, et al. Adalimumab for the treatment of moderate to severe hidradenitis suppurativa: a parallel randomized trial. Ann Intern Med. 2012;157(12):846-855.<\/li>\n\n\n\n<li>Grant A, Gonzalez T, Montgomery MO, et al. Infliximab therapy for patients with moderate to severe hidradenitis suppurativa: a randomized, double-blind, placebo-controlled crossover trial. J Am Acad Dermatol. 2010;62(2):205-217.<\/li>\n\n\n\n<li>Harii K, Hashimoto K, eds. NEW Dermatology, 3rd Edition. Nakayama Shoten, 2018.<\/li>\n\n\n\n<li>Revuz JE, Canoui-Poitrine F, Wolkenstein P, et al. Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol. 2008;59(4):596-601.<\/li>\n\n\n\n<li>Zouboulia-Vafiadis I, Alexiou GA, Karagkiozi E, et al. Hidradenitis suppurativa: epidemiology, clinical presentation and pathogenesis. J Invest Dermatol. 2019;139(6):1254-1262.<\/li>\n\n\n\n<li>Editorial Committee of the Journal of the Japanese Dermatological Association. \u201cPathophysiology and Treatment of Hidradenitis Suppurativa.\u201d Jpn J Dermatol. 2021;131(8):1567-1582.<\/li>\n\n\n\n<li>Kurzen H, Kurokawa I, Jemec GB, et al. What causes hidradenitis suppurativa? Exp Dermatol. 2008;17(5):455-456.<\/li>\n\n\n\n<li>van der Zee HH, de Ruiter L, van den Broecke DG, et al. Elevated levels of tumour necrosis factor (TNF)-\u03b1, interleukin (IL)-1\u03b2 and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-\u03b1 and IL-1\u03b2. Br J Dermatol. 2011;164(6):1292-1298.<\/li>\n\n\n\n<li>Mortimer PS, Dawber RP, Gales MA, et al. A double-blind controlled cross-over trial of cyproterone acetate in females with hidradenitis suppurativa. Br J Dermatol. 1986;115(3):263-268.<\/li>\n\n\n\n<li>Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 2009;60(4):539-561.<\/li>\n\n\n\n<li>Robinson JK, Hanke CW, Siegel DM, et al. Surgery of the Skin: Procedural Dermatology, 3rd Edition. Elsevier, 2015.<\/li>\n\n\n\n<li>Mehdizadeh A, Hazen PG, Bechtel MA, et al. The role of tobacco use in hidradenitis suppurativa. J Am Acad Dermatol. 2012;66(6):978-983.<\/li>\n\n\n\n<li>Vazquez BG, Alikhan A, Weaver AL, et al. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133(1):97-103.<\/li>\n\n\n\n<li>Wolkenstein P, Loundou A, Barrau K, et al. Quality of life impairment in hidradenitis suppurativa: a study of 61 cases. J Am Acad Dermatol. 2007;56(4):621-623.<\/li>\n\n\n\n<li>Do You Know About Hidradenitis Suppurativa? AbbVie Inc. 2018.<\/li>\n\n\n\n<li>Ministry of Health, Labour and Welfare Scientific Research Grants. Research Group on Hereditary Intractable Skin Diseases. 2021.<\/li>\n\n\n\n<li>Saunte DM, Boer J, Stratigos A, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol. 2015;173(6):1546-1549.<\/li>\n\n\n\n<li>Zouboulia-Vafiadis I, Prens EP, Kanni T, et al. Pathogenesis of hidradenitis suppurativa: dysregulation of immune pathways and barrier function. J Invest Dermatol. 2020;140(8):1569-1575.<\/li>\n\n\n\n<li>Japanese Society of Dermatologic Surgery, ed. Textbook of Dermatologic Surgery. Nankodo, 2019.<\/li>\n\n\n\n<li>Garg A, Neuren E, Cha D, et al. Evaluating patients\u2019 unmet needs in hidradenitis suppurativa: results from the Global Survey Of Impact and Healthcare Needs (INSIGHTS) study. J Am Acad Dermatol. 2020;82(2):366-376.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>\ud83d\udca1 What You Will Learn From This Article \u26a0\ufe0f If left untreated, symptoms may worsen and scarring may resultEarly diagnosis and treatment are important \u201cI am experiencing pain and swelling from a skin lesion.\u201c\u201cI want to get treatment, but I don\u2019t know which medical specialty to visit.\u201c \ud83c\udfe5 Are you troubled by painful, swollen, red &#8230; <\/p>\n","protected":false},"author":0,"featured_media":0,"parent":79973,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_yoast_wpseo_focuskw":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_yoast_wpseo_meta-robots-noindex":"","footnotes":""},"class_list":["post-80463","page","type-page","status-publish","entry","nothumb"],"acf":[],"_links":{"self":[{"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/pages\/80463","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/types\/page"}],"replies":[{"embeddable":true,"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/comments?post=80463"}],"version-history":[{"count":2,"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/pages\/80463\/revisions"}],"predecessor-version":[{"id":82015,"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/pages\/80463\/revisions\/82015"}],"up":[{"embeddable":true,"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/pages\/79973"}],"wp:attachment":[{"href":"https:\/\/ic-clinic-ueno.com\/en\/wp-json\/wp\/v2\/media?parent=80463"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}