Abstract: Daily a large number of cases with various skin diseases approaching to homoeopath and homoeopathy proves successful in such skin diseases. Hidradenitis is one of them. This article is an attempt to overview Hidradenitis which may confused with folliculitis in clinical practice.
Keywords: Hidradenitis suppurativa, Homoeopathy.
Introduction: It is a severe chronic suppurative disorder of apocrine sweat glands of skin. It presents as papules, pustules, cysts, sinuses and scar in axillae, groin and perianal areas. It is a painful condition, full of odour, and drainage because of pustules and sinus formation.
Clinical diagnosis is necessary, Can swab for bacterial cultures .
Etiology: The cause is unknown but an inflammatory condition wherein hair follicles are occuluded and become secondarily infected with Staphylococcus aureus, anaerobic streptococci [1,2]. It may be associated with obesity, diabetes, smoking, genetic predisposition and hormonal imbalance .Slight alteration in androgen level found to be a cause .
Clinical presentation: It usually presents with painful hard bump in initial phase which become large and may take form of abscess and break open up resulting in discharge of pus and blood. May lead to fistula formation in later phases.
Management: Generally cases of hidradenitis suppurativa managed with Topical and systemic antibiotics for early lesions but ineffective for chronic draining abscess/sinuses, antiandrogenic therapy and ultimately with surgery but with no satisfactorily results [1,2].
Differential diagnosis: Folliculitis, Infected cyst.
Homoeopathy for Hidradenitis Suppurativa:
Generalities: Inflammation-perspiratory gland (=hidradenities): CALC-S
Other remedies which may be indicated for hidradenitis suppurativa but prior concentrated case taking is neccessary for the desired cure to the condition. Some indications of various medicines are under:
Antim crude: Thick, hard scabs, often honey-yellow, here and there a crack oozing a green sanious fluid, burning as if immersed in hot embers. Pustules with yellowish or brown scurf.
Arsenicum album: Eruption of painful black pustules. Eruption of itchy pimples, small and tickling. Eruption of small red pimples, which increase and change into gnawing ulcers, covered with a scurf. Vesicular eruptions. Pustules filled with blood and pus. Ulcers with raised and hard edges, surrounded by a red and shining crown; with the bottoms like lard, or of a blackish-blue colour, with burning pains or shooting, principally when the parts affected become cold. Ulcers, hard on the edges, stinging, burning spongy; with proud flesh; turning black; flat; pus thin, ichorous (cancers). Fetid smell, ichorous suppuration, ready bleeding, putridity, and bluish or greenish colour of the ulcers. Thin crusts or proud flesh on the ulcers. Want of secretion in the ulcers.
Borax: Skin difficult to heal; dingy, unhealthy-looking skin; every injury tends to ulceration. Erysipelatous inflammations, with swelling and tension of the part affected, and fever. Tendency of old wounds to suppurate.
Graphites: Eruptions oozing out a thick honey-like fluid. Tetters, and other humid or scabby eruptions, sometimes with secretion of corrosive serum, or with itching in the evening, and at night. Eruption of pimples and nodules (principally under hair and on covered parts) which itch very much. Swelling and induration of the glands. Corrosive nodules. Excoriation of the skin (in the bends of the limbs, groins, neck, behind the ears), esp. in children. Unhealthy skin, every injury tending to ulceration. Proud flesh, and fetid pus, in ulcers, with tearing pains, burning, and shooting. Scrofulous and syphilitic ulcers. Burning pain in an old cicatrix.
Hepar sulphur: Erysipelatous inflammations, even with swelling and vesicles. Eruption of pimples and tubercles, painful to the touch. Unhealthy skin; every injury tends to suppuration and ulceration. Promotes suppuration. Cracks in the skin. Putrid ulcers, smelling like old rotten cheese, and easily bleeding, with shootings, sensation of gnawing (esp. at night), or with burning and pulsative pains. Suppurations; esp. after previous inflammations.
Mercurius : Engorgement, inflammation, and ulceration of the glands, with pulsative and shooting pains, hard swelling, red and shining, or without any perceptible alteration in skin. Ulcers in general; with burning on edges; hard on edges; with bloody pus; with corroding pus; with ichorous pus; having too little pus; too thin pus; thin, tenacious, sticky pus; swollen, inflamed; looking like lard; prickling; pulsating; painful on the edges; swollen on edges. Wounds ulcerate easily (and become gangrened) .
Nitric acid: Wounds and ulcers, with lancinations as by splinters, or with burning pains (esp. when they are touched), and which bleed easily. Inflammation, swelling, and suppuration of the glands. Ulcers with sanious, sanguineous, and corrosive suppuration. Pains in old scars on a change of weather. Tightness of skin. Swelling of glands.
Rhustox: Ulcers burning; with corroding pus; with ichorous pus. Hardness of skin with thickening. Swelling (hard) of affected parts. Eruptions, generally vesicular, scabby, with burning itching, appearing esp. in spring and autumn. Eruption of small pustules on a red bottom, like zona. Gangrenous ulcers resulting from small vesicles, with violent fever. Black pustules.
Silicea terra: Engorgement, induration, and suppuration of the glands. Painless swelling of the glands; they only cause very unpleasant itching. Abscesses which do not break, but burrow under the skin; exanthemata in general which corrode and spread; old and difficult to heal; which itch; fungus articularis; haematodes; spongy excrescences. Ulcers in general, wherever pus is discharged from any part of the body, or when appearing in the urine; ulcers burning, scabby; indolent; when circumscribed with redness; very high, hard ulcers; with proud flesh; with corroding pus. Ulcers of all kinds, also after the abuse of Mercury. Ulcers smell very offensive. Inflammation, softening (swelling), and ulceration of bones. Scirrhous indurations. Fistulous openings; parts around hard, swollen, bluish-red. Unhealthy skin; every injury tends to ulceration. Small wounds heal with difficulty, and suppurate profusely. Painful pustular eruptions; at last forming suppurating ulcers, Aching, itching, smarting, and boring shootings in the ulcers.
Staphisagria: Painful engorgement and induration of the glands. Unhealthy skin, easily suppurating. Frequent furunculi. Ulcers, with tearing shootings (gnawing pains), or itching smarting. Jerking and tearing round ulcers, esp. morning and evening.
Sulphur: Unhealthy skin; slightest injuries are followed by inflammation and ulceration. Ulcers with elevated margins, surrounded by itchy pimples, red or bluish areola, sharp, lancinating, and tensive pains; bleeding readily, and secreting a fetid and sanious or yellow and thick pus. Ulcers with itching in the sore. Fistulous ulcers. Furunculi. Encysted swellings, or pale, tense, and hot swellings; inflammatory abscess. Inflammation, swelling, and induration or suppuration of the glands.
- Hunter J, Savin J, Dahl M. Clinical Dermatology. Denmark: Narayana Press; Reprinted 2003.
- Barankin B, Freiman A. Dermatology Clinical Pocket Guide. Philadelphia: F A Davis Company.
- RADAR 10.0 . Repertory synthesis.
- Clarke J H. A Dictionary of Pratical Materia Medica. Homoeopathic Publishing Company; 1902.
PG Scholar, Department of Materia Medica
Swasthya Kalyan Homoeopathic Medical College and Research Centre,Sitapura, Jaipur (Rajasthan).