4 physical signs you have a commonly misdiagnosed skin condition that increases the risk of depression and scarring, and how to treat it

A close-up of a woman’s blackhead-like lumps caused by hidradenitis suppurativa.Getty Images

  • Hidradenitis suppurativa (HS) is a commonly misdiagnosed skin condition that appears on the armpits and groin.

  • HS can lead to disability and depression if left untreated.

  • Painful, itchy, and pus-filled bumps on the armpits, buttocks, genitals, and breasts are signs of HS.

Hidradenitis suppurativa is a rare but potentially debilitating skin condition that can leave patients disabled or with permanent scarring.

Man with hands in front of penis due to pain.

The man had had three days of “excruciating” penile pain before presenting to doctors.Getty

A skin condition that affects the armpits, genitals, and breasts can have devastating impacts on patients — yet it’s commonly misdiagnosed.

Hidradenitis suppurativa (HS) affects only 1-4% of the population, according to Cleveland Clinic, yet the condition can have an “extreme impact on life.” The disease can cause painful, itchy, and pus-filled bumps to form under the skin, and the size and pain of HS legions can create issues with mobility and flexibility. Patients with extensive legions can qualify for federal disability benefits.

Patients with HS are also more likely to have depression and anxiety, according to a 2020 meta analysis published in the Journal of the American Academy of Dermatology. A 2018 paper in the Journal of Investigative Dermatology found HS patients have a significantly higher risk for suicide, which authors declare a “very clear indicator of how profoundly HS can affect patients’ lives.”

The condition is commonly misdiagnosed due to patient embarrassment around seeing a doctor, a physician being unfamiliar with signs of HS, and misinformation about treatments, Men’s Health reported.

HS starts during puberty and is more common among Black people, smokers, people who are overweight, and women. If caught early, doctors can manage the condition with antibiotics, prescription ointments, hormone pills, and steroid injections, according to Kaiser Permanente.

Physical signs of the rare, but debilitating condition include itchy lumps that merge together overtime and cysts that form on the groin, armpits, or buttocks.

You have lumps the size of marbles or peas under your skin.

nurse feels patient for lumps on her breast

LUIS ROBAYO/AFP via Getty Images

The most common signs of hidradenitis suppurativa are painful, pea-sized lumps under the skin, per Mayo Clinic. The condition starts with one painful lump that can persist for weeks or months. Often, the lumps heal slowly and come back, sometimes opening up and leaking odorous pus.

HS can also present as several blackheads appearing in small, pitted areas of the skin.

Your groin, genitals, armpits, or buttocks contain pimples and are itchy.

man reaching up and itching his armpit

Getty Images

The skin condition affects areas that rub together and contain sweat glands, like the armpit, groin, genitals, breasts, and buttocks.

Texas-based dermatologist Adam Mamelak told Men’s Health that people with hidradenitis suppurativa might feel embarrassed to see a doctor because the areas the disease impacts are sensitive, leading to delayed diagnosis.

Your skin appears red, tender, and swollen in some areas.

Woman holds her breast in pain with two hands

Getty Images

HS causes hair follicles or sweat glands to become clogged and inflamed due to an abnormal overgrowth of cells. A person with the condition may experience red, tender, and swollen skin around the armpits, butt, and other areas of the body that rub together, which is an early sign of HS, according to the Cleveland Clinic.

Lumps that look like acne or boils start growing and joining together.

small boil on the skin

Getty Images

The American Academy of Dermatology Association (AADA) said cysts or boils caused by hidradenitis suppurativa repeatedly heal and reopen, causing hollow tunnels called sinus tracts to form beneath the skin.

The tunnels can cause hidradenitis suppurativa lumps to grow and join together as the condition progresses. These could develop into abscesses that fill up with fluid, like pus or blood, and become painful, according to the AADA.

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