Diagnosing HS

Diagnosing HS

HS is often misdiagnosed. In fact, it takes up to 8 years, and sometimes longer for most people to receive a formal diagnosis of hidradenitis suppurativa.

HS is often mistaken for a boil, an abscess, an ingrown hair, and STI or other type of infection.

There are several early warning signs that if recognised in time can lead to an early diagnosis and effective treatment to stop the disease progressing.

Early warning signs of HS include:

Clusters of blackheads, in particular, be on the lookout for little pits or tiny tunnels in your skin with a blackhead in each side.

A single, or multiple nodules or boil like lumps in your skin, in particular in the armpits, groin, buttocks, thighs. These lumps can appear almost anywhere on the body, so be vigilant and keep track of any unusual lumps and bumps in or on your skin They will often burst, draining pus, then go away after a few weeks, but leave a scar.

More serious signs of HS include:

Multiple lesions or lumps that become swollen, burst, and drain continuously.

The formation of little tunnels under the skin. These are called sinus tracts. You might be able to feel these, sometimes not. Often, if you press on an area of affected skin, pus can drain from a different area. You might notice several openings in your skin.

Sometimes HS lesions can become incredibly swollen and grow enormously. They have been described as golf balls, lemons, or grapefruit sized. When this happens it is incredibly painful, and you may need medical attention urgently.

Scarring that is rope-like or knotted. These scars are a result of the tunnel formation and inflammation. They can restrict your range of movement and be very painful.

It is so important to get medical advice as soon as you notice any signs off HS. There is no blood test to diagnose HS. Your doctor will visually assess the lesions and will ask you some questions about your symptoms. A good dermatologist will be trained to recognise the clinical signs of HS and be able to provide you with a diagnosis.

A set of criteria called the Dessau Criteria can be used to confirm your diagnosis. Your doctor will check the following:

– If you have typical HS lesions (like nodules, sinus tracts and scarring)
– The frequency of the lesions – are they recurring (if they have occurred more than twice during the previous 6 months)
– What areas of the body are affected – the common areas include the armpits, the buttocks, groin, thigh, and genitals. It can also affect the breasts, chest back, neck, behind the ears)
– They will also ask you about your family history
– They will look for other signs too, like inflammation and redness. They should ask you about pain and whether you can move around easily.

The doctor will confirm your diagnosis and should be able to tell you the severity of your disease and provide you with various treatment options.

The most important thing is to seek medical attention if you suspect you have HS. The above article is for informational purposes only and is not a replacement for medical advice or care.