Integrative management of hidradenitis suppurativa

Abstract

Hidradenitis suppurativa (HS) is a painful clinical condition of inflamed apocrine gland of the skin. Local tissue induration, abscess-fistulae formation, seropurulent exudation, localized pain, discoloration, scarring of the skin, and fever are the clinical signs of HS. Conventional management of HS includes systemic antibiotics, steroids, wide excision of involved tissues, and long postoperative management. In this HS of the perianal region, a 35-year-old male was managed by integrative management. He was treated by approaching infected glands through the application of Ksharasutra (~Medicated seton) and rubber seton and was prescribed castor oil (Ricinus communis) and Kanchanara Guggulu (poly-Herbo mineral compound) as adjuvant medical management. He was dressed with Apamarga Kshara Taila (AKT) once daily after sitz bath. The case was recovered in a short duration of 2 months without any untoward effects. Chemical debridement of infected apocrine glands was achieved by initial application of Ksharasutra and its periodical replacement with newer Ksharasutra at the interval of 7 days (till 6 weeks). Rubber seton provided drainage of exudation and tissue fluids without local skin irritation and inflammation. Local wound management by AKT and systemic medicaments aided in faster recovery. The patient has been living without recurrent episodes for the last 2 years.

Keywords

• hidradenitis suppurativa
• ksharasutra (~medicated seton)
• rubber seton