Epidemiology, pathology, and treatment of axillary hidradenitis suppurativa.

The epidemiology, pathology, and management of axillary hidradenitis suppurativa were examined in 11 patients with this disease. On the basis of this study, the following predisposing factors were incriminated in the epidemiology of the disease: predilection of the disease for women, obesity, hair removal by a safety razor, antiperspirants and deodorants, and local pyogenic infections distant from the axilla. Because antiperspirants do not effect transepidermal water loss of axillary skin, their potential deleterious effects are probably related to their chemical irritant effects on cut, nicked, or irritated axillary skin. Treatment of this disease will vary according to its severity. Incision and drainage are usually needed to treat the localized disease. Specific measures must also be instituted to prevent progression of the disease (eg, weight reduction, avoidance of safety razor and antiperspirants and deodorants, and control of localized pyogenic infections distant from the axilla). Management of the chronic phase of the disease is primarily excision of infected axillary skin.