Business Insight presented by Arlington Dermatology What disease is it? When patients schedule appointments with our practice for the first time, they often do not fully identify their medical problem. What we hear is rash, pimples, bumps, skin changes, moles, and similar. Patients do not need to provide any more details. We are prepared for general description of their issues, and it is our job to get into details during the visits. When we meet those patients in the exam room, we finally look and diagnose their true problem. Often, we are not sure, and we establish a so-called differential diagnosis. This means that we may have a couple of possible options, just from the visual perspective, and a biopsy is needed. Biopsy for a dermatologist is like an x-ray for another specialty. It is looking deeply into the skin layers and tells us what abnormalities are seen. Pathology exams can be quite complex. Sometimes, it is just a simple confirmation of what we have seen, but some other times, a longer workout, with special staining, is needed. Pathology results are usually sent outside of the clinic to a hospital derma pathologist, whose job is just to read biopsies all day long. Thus, this kind of doctor has the most possible experience to put the final diagnosis correctly. Some insurance companies require a pathology report before we can schedule any procedure or treatment. Often, they request medical records to make sure that a procedure or treatment are medically necessary. If we do not provide it, the treatment can be denied. Some diseases are easy to identify just be visual impression and touch. Some others may be less typical and less frequent. When patients state that they experience painful bumps under their skin, we ask about locations. If those bumps are multiple and located under arm, breast, or other 'fold' areas, we suspect HS. HS is an abbreviated form of a very difficult name Hidradenitis Suppurativa. It is an immune system disorder, usually starting in puberty, which is very painful and cumbersome to treat. The bumps or lumps develop in 'folds, usually where skin rubs against itself, they grow like cysts, and rupture discharging odors that are also very ma unpleasant. They heal slowly and often leave scars. In some cases, they need to be removed surgically. It is a chronic disease, so healing one or two does not cure the problem. The new ones will show up again. There are some characteristics of patients who develop this disorder, but many patients do not fit any pattern. It is more frequent with females than males, and it does have hormonal background. Sometimes female patients have reproductive organs problems as well. There is no 100% successful treatment for HS. We are still searching for the root cause of it and what is available on the pharmacological market is not fully effective. However, there are many clinical studies attempting to nail down this very uncomfortable disease. It seems like we see many options, and some are very hopeful. The treatment is systemic and in the form of injections. Most of those injections were already studied for other indications and are generally safe. Of course, the studies are done to establish how effective those new treatments are. If you need help with your 'lumps' and would like to discuss what you experience, please, call our research crew. They will be able to see you at no charge and advise if we can help. Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight presented by Arlington Dermatology What disease is it ? When patients schedule appointments with our practice for the first time , they often do not fully identify their medical problem . What we hear is rash , pimples , bumps , skin changes , moles , and similar . Patients do not need to provide any more details . We are prepared for general description of their issues , and it is our job to get into details during the visits . When we meet those patients in the exam room , we finally look and diagnose their true problem . Often , we are not sure , and we establish a so - called differential diagnosis . This means that we may have a couple of possible options , just from the visual perspective , and a biopsy is needed . Biopsy for a dermatologist is like an x - ray for another specialty . It is looking deeply into the skin layers and tells us what abnormalities are seen . Pathology exams can be quite complex . Sometimes , it is just a simple confirmation of what we have seen , but some other times , a longer workout , with special staining , is needed . Pathology results are usually sent outside of the clinic to a hospital derma pathologist , whose job is just to read biopsies all day long . Thus , this kind of doctor has the most possible experience to put the final diagnosis correctly . Some insurance companies require a pathology report before we can schedule any procedure or treatment . Often , they request medical records to make sure that a procedure or treatment are medically necessary . If we do not provide it , the treatment can be denied . Some diseases are easy to identify just be visual impression and touch . Some others may be less typical and less frequent . When patients state that they experience painful bumps under their skin , we ask about locations . If those bumps are multiple and located under arm , breast , or other ' fold ' areas , we suspect HS . HS is an abbreviated form of a very difficult name Hidradenitis Suppurativa . It is an immune system disorder , usually starting in puberty , which is very painful and cumbersome to treat . The bumps or lumps develop in ' folds , usually where skin rubs against itself , they grow like cysts , and rupture discharging odors that are also very ma unpleasant . They heal slowly and often leave scars . In some cases , they need to be removed surgically . It is a chronic disease , so healing one or two does not cure the problem . The new ones will show up again . There are some characteristics of patients who develop this disorder , but many patients do not fit any pattern . It is more frequent with females than males , and it does have hormonal background . Sometimes female patients have reproductive organs problems as well . There is no 100 % successful treatment for HS . We are still searching for the root cause of it and what is available on the pharmacological market is not fully effective . However , there are many clinical studies attempting to nail down this very uncomfortable disease . It seems like we see many options , and some are very hopeful . The treatment is systemic and in the form of injections . Most of those injections were already studied for other indications and are generally safe . Of course , the studies are done to establish how effective those new treatments are . If you need help with your ' lumps ' and would like to discuss what you experience , please , call our research crew . They will be able to see you at no charge and advise if we can help . Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net