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ACUTE MANAGEMENT OF FLARES
ACUTE MANAGEMENT OF FLARES
Disease flares, characterized by the acute onset of painful nodules or abscesses, are a hallmark of HS (Fig. 54-2). Medical therapy in HS is aimed at limiting the incidence of flares and reducing inflammation. However, patients continue to be susceptible to flares during medical treatment. Therefore, adequate management of flares is an essential part of the treatment strategy as the nodules and abscesses can be extremely painful and interfere heavily with daily life. Care must be taken to properly discriminate abscesses
from inflammatory nodules in these situations as they require a different approach. Differentiation is based upon the fluctuating nature of a fluid collection (i.e., abscess) compared with the firm nature of an inflammatory nodule. Acute inflammatory nodules often benefit from intralesional corticosteroids that inhibit the synthesis of proinflammatory cytokines,15 whereas abscesses require incision and drainage to rapidly relieve symptoms of pain and pressure.16โ18
Figure 54-2. Acute HS lesion in the right axilla.