Is It HS? 6 Common Misdiagnoses Black Folks Should Look Out For

Hidradenitis suppurativa (HS).

This odd-sounding condition is actually a chronic skin condition. Commonly causing painful, inflamed lumps that may turn into abscesses, HS can get serious if left untreated.

However, because the symptoms of HS overlap with those of several other conditions, it’s often misdiagnosed. Fortunately, there are ways to know what is what, and your doctor can use a variety of tests to determine if your issues are from HS or something similar.

Understanding six common misdiagnoses can help you identify the true nature of the problem and seek the best treatment available.

1. Abscesses

In short, abscesses are like little pockets or collections of pus that develop in the tissue. Usually the result of bacterial infections, they like to show up as swollen, red, and painful lumps, kinda of like the lesions caused by HS. The difference is, that abscesses usually stem from a particular infection and will often stay in one area of the body. With HS, however, recurrent abscesses can show up in all kinds of regions, from the armpits to the groin and under the breasts.

2. Acne

We’ve all heard of acne, especially as teenagers, but did you know acne can cause many similar conditions to that of HS? Whether it’s pimples, blackheads, or cysts from blocked hair follicles, acne is often confused with HS. Here’s where the similarities end, though. While acne may trigger painful cysts that resemble HS, they’re usually on your face, back, or shoulders. HS, by contrast, hits areas where the sweat glands and friction occur, and the lumps actually go under your skin, resulting in ‘tunnels’ known as sinus tracts.

3. Carbuncles

A carbuncle is basically a cluster of boils that comes when you’re infected with bacteria. Similar to what you see with HS, carbuncles can get painful and fill with pus, and even show up in similar body regions. The key difference, though, is that carbuncles are caused by those bacterial infections and usually do not show up again and again like HS. When it comes to HS, any lesions like that are persistent and come back with time.

4. Sexually Transmitted Diseases (STDs)

Certain STDs, like herpes or syphilis, trigger lesions or ulcers around the genitals, and in some cases are mistaken for HS. For instance, herpes leads to painful blisters that turn into ulcers, and syphilis may cause firm, round sores. However, HS is a little different. It causes inflamed nodules and those sinus tracts we previously mentioned. With STDs, the symptoms are different and you’ll also have full-body or systemic signs of disease as well.

5. Folliculitis

Folliculitis occurs when your hair follicles get inflamed due to infection, friction, or some kind of irritation. This results in small, red, and tender bumps. The thing is, folliculitis is frequently mistaken for the early stages of HS because both conditions can cause the inflammation of your follicles. That said, folliculitis usually causes more surface-level bumps that are less severe and painful than the deep surface issues caused by HS.

6. Ingrown Hair

An ingrown hair is a hair that grows back into your skin and forms a painful bump that may or may not catch an infection. HS lesions may look similar, especially if the ingrown hair is inflamed or filled with pus. However, here’s what to remember. With ingrown hairs, they’re usually isolated and come from things like getting hair removed or shaving. HS, of course, is much different and is a chronic condition that causes recurrent and widespread lesions in various areas of your body.

Getting the Right Diagnosis

Due to all these overlapping symptoms, it can be hard to know what’s what! That’s why diagnosing HS requires a comprehensive approach. Your doc may do the following:

Medical History and Physical Symptoms: Used to look at your personal medical history and family history, as well as any physical signs detectable on your body.

Swabs and Cultures: Swabs from lesions may eliminate bacterial infections as a cause. A very important step.

Histopathology: A biopsy of a lesion that can rule out simple infections or acne.

Imaging Tests: Tests like ultrasounds or MRIs actually see the inflammation and presence of sinus tracts under the skin.

International Hidradenitis Suppurativa Severity Score System (IHS4): Finally, a scoring system that determines the severity of your HS based on the type and number of your lesions.

With these important tests and steps, your team of healthcare providers can quickly determine what you’re suffering from. Whether it’s HS, something else, or both, you can rest assured knowing that you are in good hands and that your issues are clearly being examined.

With the appropriate tests and good specialists, you’ll be well on your way to treating your condition and getting things under control!