Clinical features

Presentation:

• more common in women - affects women 1-5x more than men; average age of onset 23 years of age
• most commonly affects the groins and axillae - less often affects the perianal region, inframammary region, suprapubic region or in the abdominal folds
• the first clinically noticeable hidradenitis suppurativa skin alteration is typically a single, painful, deep-seated inflammatory nodule (1–2 cm in diameter) occurring in intertriginous areas, such as axillae, inframammary folds, groins, perineum, or the buttocks. The nodule
  often persists for weeks and might turn into an abscess.
• on average, patients develop one to two new inflammatory
  nodules or abscesses per month.
• pain is the most troublesome symptom reported by patients, followed by often foul-smelling discharge from abscesses
• the disease course is characterised by an unpredictable fluctuation between periods of low-level activity and exacerbations (i.e. flares) with severe pain and formation of new inflammatory nodules and abscesses.

Reference:

1. Sabat R et al. Hidradenitis suppurative. Lancet 2025; 405: 420–38