Anyone had plastics post RNY to help treat HS?
Hi all. I have an auto immune disorder called "Hidradenitis Suppurativa, which affects the skin under my arms, and around my thighs. It is very painful, and has gotten much worse since surgery. I wonder if this is due to excess skin causing more areas of friction, and moisture. These are classic thing which can cause flare ups in HS sufferers.
Here is my very specific question: does anyone out there reside in Canada ( more specifically Ontario), and have experience with OHIP, or private insurance, getting coverage for plastics because of the added complication of HS
It's not an auto-immune disease. It's an infection involving a certain type of sweat gland in hair baring areas. Surgery is usually last resort if you fail antibiotics and such. If you have significant infected areas you normally would NOT do a super-complex contouring type procedure (versus a simpler I&D or excision and closure) during the treatment as you would increase the risk of wound infections and such. Sometimes treating the area with a hair-reduction laser (eg. a diode laser) can help decrease flare ups
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From everything I have read, the most current research is now strongly suggesting that it is an auto immune disorder, and it certainly has strong connections with other inflammatory, auto-immune diseases. I have had it for 25 years and have read quite a bit about it since it affects everyday of my life. It is also not an infection. It is a disorder that causes poor function of the aprocine glands which in turn cause the glands to become easily blocked with fluid. A complication of the disorder, is the infection of these glands.
I understand that simple exercision is a last resort. I have been on many antibiotics with no success, though I have not chosen to go the route of surgery at this point. The progression of HS is marked by periods of flare ups, so there are sometimes where I don't have anything for months. If I ever chose to have plastics, it would be during a time of "remission". As I will consider plastics because of RNY, in the future. I was wondering if it would kill 2 birds with one stone (clearing up the excess, and limiting the amount of friction, moisture, etc... to the affected areas), as I have a lot of excess skin on and under my arms, as well as my stomach (pani), and thighs.
I think it would be mis-characterizing the literature to say that it's currently "strongly suggested" this is an auto-immune phenomena per se, but there are some markers of weird inflammation in these areas that have led to speculation that perhaps you could treat the condition with immuno-suppresors like you would some of the auto-immune disease.
It clearly is associated with heredity, obesity, acne-prone individuals, hair individuals, etc.... who have ingrown hairs. Once you get into a cycle of infection/scarring it tends to be hard to treat conservatively. Most of the patients (by far) that I encounter with this are African American and tend to have a preceding chronic folliculitis thing going on. Surgery can work well, but it can be frustrating for recurrence of other hair follicles adjacent.
blogging on all things plastic surgery at Plastic Surgery 101