Hidradenitis Suppurativa : Symptoms, Causes and Treatment

◉ Causes

Verneuil's disease develops when hair follicles become clogged. The exact cause of this is not known. Experts believe it could be related to hormones, genetic predisposition, smoking or being overweight.

It is not caused by infection or soiling, and it cannot be transmitted to other people.

◉ Hidradenitis suppurativa risk factors

Factors that increase your risk of developing Hidradenitis suppurativa include:

  • Age : The risk of Hidradenitis suppurativa is highest in people in their 20s and 30s. It is more rare after 50 years
  • Gender : Women are more likely to develop Verneuil's disease (3 women / 1 man), although men generally have more severe symptoms.
  • Ethnicity : The prevalence of the disease is disproportionately high among black people.
  • Family history : 30 to 40% of patients have at least one affected family member.
  • Smoking : Smoking increases risk and worsens symptoms.
  • Obesity
  • Diabetes, hypertension, hypercholesterolemia, etc.
  • Stress
  • Too tight clothes

◉ Hidradenitis suppurativa symptoms

Early symptoms of Hidradenitis suppurativa can range from mild itching and discomfort to red, tender, swollen areas or a painful inflamed bump.

The lesions generally affect both sides of the body, they are limited to a single place or to several areas at the same time.

Verneuil's disease is divided into three stages, depending on its severity, called Hurley stages:

  • Stage 1: Usually presents as an inflammatory nodule or abscess, single or multiple, without sinus tracts or scars.
  • Stage 2: Usually presents as abscesses and nodules, isolated or multiple, widely separated, with sinusitis formation or scarring (rope-like elevation of the skin).
  • Stage 3: Usually presents as diffuse or near-diffuse involvement with multiple interconnected sinus pathways, scarring, and abscesses over the entire surface
Hidradenitis suppurativa stage 3

Hidradenitis suppurativa stage 3

Lesions usually occur in areas where you have hair or where your skin rubs together, such as :

  • Under the arms
  • The groin
  • Between the buttocks
  • Between the thighs
  • Under the breasts
  • In the folds of the belly
  • On the neck
  • Behind the ears

Note :

  • Misdiagnosis is common, with early lesions of Verneuil's disease often mimicking other diseases.
  • The course of the disease is highly variable

◉ Diseases associated with Verneuil's disease

People with Hidradenitis suppurativa often have other medical problems:

◉ Diagnosis

The diagnosis is essentially clinical, no biological or pathological examination is necessary, in particular in well-developed lesions.

Clinical diagnosis requires recognition of morphology, location (intertriginous areas, areas containing apocrine glands) and chronicity of the disease process (prolonged course with periods of activity and remission).

The doctor will ask questions and do a physical exam:


◉ Differential diagnosis

◉ Treatment

There is no cure for hidradenitis. Drug treatment, surgery, or both can help control symptoms and prevent complications.


  1. A Guillet et al - Verneuil's disease, innate immunity and vitamin D: a pilot study
  2. vial - Verneuil's Disease
  3. mayoclinic - Hidradenitis suppurativa
  4. Geneva dermatology - Hidradenitis Suppurativa (Verneuil's Disease)
  5. Surgery of the Anus, Rectum & Colon (Third Edition), 2008 - HIDRADENITIS SUPPURATIVA
  6. Fred F. Ferri MD, FACP, in Ferri's Clinical Advisor 2022 - Hidradenitis Suppurativa
  7. Healthline - Everything You Should Know About Hidradenitis Suppurativa
  8. NHS - Hidradenitis suppurativa
  9. Medlineplus- Hidradenitis Suppurativa
  10. Marina Jovanovic ET AL - Hidradenitis Suppurativa
  11. Merck manuals: Jonette E. Keri , - Hidradenitis Suppurativa
  12. Kimberly Ballard et al - Hidradenitis Suppurativa
  13. John R Ingram, MD, PhD - Hidradenitis suppurativa: Pathogenesis, clinical features, and diagnosis
  14. Cleveland clinic - Hidradenitis Suppurativa
  15. Hessel H et al - New insights into the diagnosis of hidradenitis suppurativa: Clinical presentations and phenotypes