A history of confusion quote from paper by Dr Van der Werth UK 2004

First of all, there was the 'apocrine misunderstanding'. In 1833, six years before the first clinical description of hidradenitis, Purkinje discovered sweat glands in human skin. Twelve years later, in 1845, Robin followed with the first description of the structure and location of apocrine glands, so that in 1854 another Frenchman, Verneuil, having studied Velpeau's work, became the first person to relate the disease he termed 'hydrosadenite phlegmoneuse' to apocrine glands. He went on to publish four papers on this condition in which he confirmed his belief that hidradenitis represented a disease of apocrine glands, a view that became generally accepted with time.

It took a series of detailed histopathological studies in the 1980s and 1990s to prove that hidradenitis is primarily an acne-like disease of follicular occlusion where apocrine glands only become involved in the context of an intense perifollicular inflammation. The initial process was found to be one of cornification of the follicular infundibulum, followed by an early inflammatory reaction and ultimately the rupture of the involved hair follicle. This leads on to the formation of abscesses which can either subside spontaneously over a matter of days or which occasionally progress into a chronic process of cutaneous or subcutaneous tunnelling, referred to as sinus tract formation. (1-4)

Knowledge of this process has given us a better understanding of the disease and has helped to point us towards treatment attempts resembling those successfully used in acne vulgaris. Before these studies had emerged many hidradenitis patients had received treatments for presumed apocrine gland infections--with virtually no benefit at all.

HIDRADENITIS SUPPURATIVA is often misdiagnosed or treated as isolated incidences of acute abcesses. (See Fox-Fordyce, Dowling-Degos and Hailey-Hailey diseases.)

HIDRADENITIS SUPPURATIVA most commonly affects the following areas where apocrine glands are concentrated: Axillae (armpits), periareolar (around the nipples), intermammary zones (breast region), pubes (pubic region), infraumbilical midline (beneath the belly-button), gluteal folds (crease of the buttocks), and genitofemoral areas (top of the thigh in genital area).

HIDRADENITIS SUPPURATIVA sufferers for psycho-social reasons may not report their disease and are less likely than the general populace to seek second opinions.

HIDRADENITIS SUPPURATIVA activity is directly related to stress.

HIDRADENITIS SUPPURATIVA is more common in women than men, although sex differences for occurrence in the armpit is negligible.

Some HIDRADENITIS SUPPURATIVA patients do go into remissions which can last anywhere from several months to several years.

HIDRADENITIS SUPPURATIVA is a "disability" which does not allow sufferers to perform normal work functions in many cases and has some drastic effects on normal social activities.

Some studies indicate that HIDRADENITIS SUPPURATIVA may be as common as 1% of the population.

Background: Hidradenitis suppurativa is an annoying chronic condition characterized by swollen, painful, inflamed lesions in the axillae, groin, and other parts of the body that contain apocrine glands. The disease is a chronic acneiform infection of the cutaneous apocrine glands that also can involve adjacent subcutaneous tissue and fascia. Velpeau first described the condition in 1839.

History: The most common presentation is that of painful, tender, firm, nodular lesions under the arms.