Hidradenitis

My husband is a quadraplegic and has had an open area in his groin for 10 years. (Dx as hidradenitis although some docs disagree and say it's a pressure sore) It gets bigger and smaller, bigger, and smaller but when it's bigger it has a strong odor. Can you suggest anything? Thanks

[BhumikaMD]

Hi,

You would need a confirmed diagnosis about whetehr this is pressure sores or hidradenitis before the further management can be planned.

The nodules of hidradenitis suppurativa may need to be drained in the emergency department, particularly if they are very large, fluctuant, and painful. Antibiotics are indicated if cellulitis or fever is present, and you should get admitted if you have fever, etc.

Surgical consultation may be obtained for removal of sinus tracts, curettage, and exteriorization of the gland. Excision and skin grafting may be helpful for severe intractable cases. Also, surgery should be considered in early cases because the area to excise is smaller and less damaged from recurrences. The CO2 laser has been used to strip away glandular tissue.

Tetracycline and erythromycin may be helpful on a long-term basis, and cephalosporins often will help in acute cellulitis. On a short-term basis in the emergency department, dicloxacillin is considered a good choice. Topical products, such as benzoyl peroxide, may be helpful. Topical and intralesional injections of corticosteroids are sometimes helpful.

If the symptoms still persist, consult your skin specialist or dermatologist.

Let us know about how you are doing and if you have any other doubts.

Regards.