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Skin Care and Diseases

Underarm boils

06/22/2005

Question:

I am a 32 year old,5.9`,310lb,black female who continuously suffers from boils under my arms. I`ve heard that it`s just my shirts rubbing under there, but I`m wondering if its because of my weight or is it something else like cancer. I don`t want to over react, but should I get them checked out? What do you think they could be caused by?

Answer:

You have clearly described the disease process known as hidradenitis suppurativa. You are abscessing a form of sweat glands that gives us odor and they are highly concentrated in the axilla and groin.  They are hormone-dependent and the disease process usually develops in puberty forward.  Your excess weight does make this worse but is not the cause.  It is not cancer.  The chronic infections may effect your health, however. 

There are a number of approaches to the disorder suggesting that there is not one best treatment.  Some physicians have had success treating patients with Accutane; some with incision and drainage; some with excision of the entire armpit with grafting; some with injection of steroids and systemic antibiotics.  All of these may have an impact, but as you can see none is totally curative.

Recently, one of the new biologics, Infliximab (remicade), has been reported to produce dramatic improvement in severe hidradenitis suppurativa.  In concert with your board certified dermatologist and your insurance company, that may be an area that should be explored if your other health factors will allow the use of that drug.  I would suggest that you do contact a board certified dermatologist and possibly one in a medical center for consultation and assistance.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati