Verneuil’s disease is named after Aristide Stanislas Auguste Verneuil de Saint-Martin, the French surgeon who first described it in 1854. This fairly rare skin disease is also called “hidradenitis”, “hidradenitis suppurativa ” or “hidrosadenitis suppurative”.
Verneuil’s disease or hidradenitis suppurativa: what is it? The dermatologist’s definition
Verneuil’s disease is a chronic dermatological pathology (or “dermatosis”) which affects around 1% of the French population – there are therefore around 650,000 patients in France. “It is characterized by lesions (abscess) very painful which form at the folds. It is a painful, debilitating and unpleasant disease on a daily basis.” describes Dr. Pierre-André Bécherel, dermatologist.
Verneuil’s disease affects women more than men: it affects approximately 3 women for 1 man. “It is a disease with a genetic, familial component: it is therefore transmitted to children in more than 50% of cases.” estimates Dr. Pierre-André Bécherel. The transmission of Verneuil disease would be autosomal dominant, with variable penetrance (which means that the disease is not systematically transmitted to all generations).
Other risk factors have been identified for Verneuil’s disease: overweight and obesity (with a body mass index greater than 25) and smoking. In addition, exceptionally, treatment with lithium could be a triggering factor for the disease. “This pathology generally appears in adolescence or young adults.” notes the dermatologist.
Symptoms: abscesses in the folds (face, armpits, groin, etc.)
Verneuil’s disease is easily recognizable on clinical examination. Its number 1 symptom is the formation of lesions (cysts, abscesses, etc.) in the folds of the skin – the vulvar fold in women, the genital folds in both sexes, under the breasts, between the buttocks, at the from the groin, under the armpits…
However, certain areas of the body are more affected than others. Thus, anoperineal Verneuil’s disease represents 20% of the locations of the disease. It is frequently associated with damage to the folds of the groin, the scrotum or the pubic area (90% of cases), the armpits (26%), the region behind the ears (6%) or the nipples. (4%).
“Very concretely, these are very painful pimples, “balls of pus” with possibly a purulent and/or smelly discharge.” specifies the dermatologist. These lesions can be associated with severe acne and/or a digestive disease (Crohn’s disease, for example) and/or inflammatory rheumatism (such as ankylosing spondylitis).
Please note: approximately 10% of patients affected by Verneuil’s disease also suffer from a pilonidal cyst, a ball of pus located under the skin, at the junction between the back and the buttocks. This lesion can only be corrected by surgery.
Can Verneuil disease develop into cancer?
Cancerization of Verneuil disease lesions is extremely rare. In general, it only occurs after a very long course of the disease (more than 20 years).
What are the causes of Verneuil disease? Are sick people contagious?
The exact causes of Verneuil’s disease remain unknown to this day. “Research is underway. For example, we know that there is a genetic factor, but no gene has (for the moment) been absolutely identified” underlines Dr. Pierre-André Bécherel.
It is important to note that Verneuil’s disease is in no way the result of poor hygiene. The sick are absolutely not contagious.
Unsurprisingly, Verneuil disease has a “major impact“on the quality of life of patients:”patients suffer from loneliness, social isolation, increased work stoppages linked to pain and discomfort caused by the lesions, may have sleep disorders, difficulty moving around, doing physical exercise, etc. .“
Note: like other inflammatory pathologies (such as Crohn’s disease, for example), Verneuil’s disease progresses in flare-ups. “Flare-ups (with multiplication of lesions) are favored by stress and emotional shocks” specifies the specialist.
How is Verneuil disease (hidrosadenitis suppurative) diagnosed?
The diagnosis of Verneuil’s disease is only clinical: “no additional examination, no biopsy is necessary, because the lesions are sufficiently characteristic” underlines Dr. Pierre-André Bécherel. The diagnosis is made by the dermatologist, after referral by the general practitioner. The diagnosis is usually quite rapid, particularly at an advanced stage of this skin disease.
Antibiotics, surgery… What treatments for Verneuil disease?
The treatment of Verneuil’s disease is carried out in three parts: as first intention, the dermatologist will prescribe a long-term antibiotic medication (doxycycline). If this is not sufficient, biotherapy may be indicated:anti-TNF are also offered in cases of Crohn’s disease or rheumatoid arthritis” specifies the dermatologist.
Finally, for the largest and most resistant lesions (which we observe in particular in severe forms), surgery may be offered to the patient (excision of diseased tissues). Good news : “it seems that over time, the disease tends to wear itself out: we can thus observe a regression of the lesions in the space of a few years” says Dr. Pierre-André Bécherel.
In addition to medical treatment (antibiotics, anti-TNF) and surgery (for the most significant lesions), other approaches may be considered:follow-up by a nutritionist in the event of overweight or obesity, addiction treatment for smoking cessation, or pain management follow-up by an algologist” suggests the specialist. So-called “soft” medicines, for their part, have not been the subject of an evaluation in the context of Verneuil’s disease: “However, yoga and relaxation are worth trying…“
Thanks to Dr. Pierre-André Bécherel, dermatologist at the Antony Private Hospital (Ramsay Santé group).
Source : French National Society of Colo-Proctology (SNFCP)
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