The Age of Hidrosadénite – Rob Howes

The Age of Hidrosadénite

HS is a disease of the skin. HS lesions vary in size from a pea to a pigeon’s egg. HS, at times, may mimic a pustule, or a tubercle, or even a boil. In people who have a predisposition for HS, continuous or frequently repeated local irritation may trigger the beginning of HS.

Two essential characteristics constitute HS and give it a distinct nosological place:

1. Its pathogenic modality, which is inflammatory and suppurative;
2. Its anatomical seat, namely the armpit, anus, scrotum, perineum, labia majora, face, buttocks, & the external auditory canal.
Considered according to its nature, HS is sometimes of external cause, and sometimes of internal cause. Continuous or frequently repeated local irritation may produce suppurative but not infectious inflammation.’

The above sounds like an incredibly modern medical perspective of Hidrosadénite Suppurative to me. However the above is a paraphrased Google Translation of a ‘Verneuil’s Hidrosadénite’ book chapter by Dr. Bazin and Dr. Guerard from 1865. It is a shame that these early works on HS only exist in the mid-19th century Parisian French language. Perhaps a studious English translation in the early 20th century may have helped a lot more people to have a lot less pain? There are only two words I deliberately left out of the above paraphrasing of Bazin & Guerard Hidrosadénite book chapter- ‘sweat gland’ ( these words are contained within the disease name HS ). Verneuil wrote 49 pages in three articles on Hidrosadénite between 1864 & 1865, and Bazin and Guerard wrote another 23 pages on Hidrosadénite in 1865. I wonder what else may have been left out by non-French speaking doctors after 1865.

One of many physical triggers of Hidrosadénite listed by these doctors from 1864 to 1865 is ‘forced marches’. If Dr’s Verneuil, Bazin & Guerard had hopped aboard HG Wells’ time machine to 2002, they would have been my expert witnesses confirming that HS may be triggered or aggravated by military service. It is a nice ‘what if’ scenario, but not very realistic I guess. However, written translations from French to English do survive the passage of time, and may have helped HS people in need over the past 150 or so years.

This may be the earliest citation and earliest expert peer-review of Verneuil’s three 1864 and 1865 articles which comprehensively name, classify & describe Hidrosadénite as a distinct disease for the first time in history. Within Dr. Verneuil’s second article he discusses his respect and admiration for Dr. Bazin’s work on scrofula ( later known as cutaneous tuberculosis ). And if the translation is semi-correct, than Dr Verneuil may have lent all his unpublished notes on Hidrosadénite to Dr’s Bazin & Guerard, prior to publication of his two 1865 articles on Hidrosadénite. ‘I can not thank Mr. Verneuil too much for the —– with which he has made available to me his researches on the affections of the glands Sudoripares, and in particular its last article, then in the process of publication on Hidrosadénite and sweat abscesses.’ ( Paraphrased Google Translation of book chapter note by Dr. H. Guérard, Student, Saint-Louis Hospital ).

In theory, the 2017 disease of Hidrosadénite Suppurative that we know today did not exist in 1833, 1865, 1949, or 2002. Until 2006, and from 1833, there have literally been thousands of medical definitions & descriptions for HS. Without any kind of global medical agreement these diseases may be the same thing, they may not be the same thing. The 2017 disease Hidrosadénite Suppurative was first described in Dessau, Germany by a gaggle of good global doctors, in the year 2006. The 21st century disease of HS is now 11 years old. The 2006 Dessau definition of HS was as follows “Hidradenitis Suppurativa / acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating disease of the terminal hair follicles that usually manifests after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillary, inguinal and anogenital regions”.

What if Dr’s Verneuil, Bazin & Guerard had hopped aboard HG Wells’ time machine and found themselves dining on strudel in Dessau, 2006? Would they have jumped out of their seats excitedly shouting a tripartite ‘Yea’ to the proposed consensus definition of HS? I think so, but their shout would have been in French.

Rob Howes
Melbourne, Victoria, Australia
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Historical References (PDF viewable in browser):

1865 Bazin & Guerard Fr In French De l’Hidrosadénite pages 333 to 358
1864 Verneuil FR In French hidrosadénite Article 1
1865 Verneuil FR In French hidrosadénite Article 2
1865 Verneuil FR In French hidrosadénite Article 3


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