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Hidradenitis Suppurativa (HS)

In this section, you or a loved one can find out more about medical treatments and practical information about hidradenitis suppurativa (HS). Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step toward becoming an active decision-maker in your care plan.

WHAT IS HIDRADENITIS SUPPURATIVA?

"Hidradenitis" is a Greek word that means inflammation of the sweat glands, and "suppurativa" means Pus-forming, which can be a more severe symptom of the condition.

HS is a Chronic, long-term skin disease. It causes swollen red lumps under the skin (which can be large sometimes) that are often very painful, sore or tender. These lumps sometimes leak Pus, which can create an unpleasant-smelling odor. In HS, these lumps tend to grow around the armpit and groin/genital areas, but it's also common for them to grow under the breasts, on the buttocks and/or on the inner thighs.

The soreness, inflammation and Pus from HS may resemble bad pimples but HS is not Acne; it is an entirely different condition.

WHAT CAUSES HIDRADENITIS SUPPURATIVA?

The exact cause of HS is unknown. This disease involves the plugging of the Hair follicles where sweat glands are present.

Though the exact causes of HS remain a mystery, it seems specific defects within Hair follicles may be responsible for its symptoms. It is not an Infectious disease, nor is it a condition related to poor hygiene.

Areas where we have Apocrine glands, such as the armpit and groin, are where HS Lesions tend to occur. Recent research suggests that the lumps, Boils and inflamed skin develop when sweat gets trapped inside the Sweat gland tubes that are connected to Apocrine glands inside Hair follicles.

When sweat becomes trapped, it builds up in the Hair follicle, Swelling under the skin until it bursts. Sometimes the trapped sweat mixes with bacteria in the Hair follicle, and an intensely painful and infected boil is formed. The boil might grow until the skin above and around it becomes very inflamed and painful, and Pus leakage may occur. This kind of lesion may burst as well.

Although HS can be seen on the surface of the body, it is actually an Inflammatory disease. This means that an irregularity in the person's Immune system is causing the disease and the skin irregularities.

People with HS often worry they might pass the disease on to someone close to them. Rest assured, this cannot happen – HS is not a Contagious disease. People with HS can have normal and close contact with others with no danger of HS spreading from one person to another. It is also important to remember that HS has nothing to do with poor hygiene – a common misconception about the disorder.

Though the exact causes of HS remain unknown, there are some risk factors associated with this disease:

Age

  • HS can occur at any age but it most commonly begins after adolescence in people in their early 20s

  • Risk of developing HS drops off after ages 50 to 55

Gender

  • Women are more likely to develop HS than men

Genetics

  • Research shows HS may run in families

  • People diagnosed with HS tend to have a family member who has it too

Hormones

  • Because the condition is more common during the reproductive years, researchers think HS might be connected to Sex hormones. No evidence of a direct link between the two has yet been proven, however.

Medical research also shows that smoking and obesity seem to put a person at greater risk of developing HS. However, researchers still aren't sure whether it is obesity that can lead to HS, or the reverse.

Some of these risk factors for HS, such as smoking, obesity, hormonal changes and excessive sweating, may actually worsen symptoms in people who already have HS.

WHAT ARE THE EFFECTS OF HIDRADENITIS SUPPURATIVA?

HS lumps usually appear on the skin where Apocrine glands are found in Hair follicles, and where the skin is also creased or rubs together.

Everyone is different. One person's HS symptoms may not be like those of another person who has it. There are, however, signs of the condition most people with HS will have at some point: inflamed (red, sore and swollen) areas of skin that have painful LesionsNodules and Boils in them. Depending on how severe HS is, the sores in these areas may hurt (particularly when they are pressed), sometimes making movement more difficult; they may leak Pus or be itchy, and scarring can also occur.

HS varies from mild to severe. Mild cases of HS can consist of tender small bumps, blackheads or a few Boils. In more severe cases a person can have painful, recurring Lesions that can burst or leak liquid. An unpleasant smell can accompany these leaking Lesions.

Not all cases of HS are progressive (increase in severity over time). However, sometimes HS Lesions come back in the same place or nearby many times, becoming more severe as they recur. That's why diagnosing and properly managing HS as early as possible is so important.

WHICH BODY PARTS ARE AFFECTED?

Hidradenitis suppurativa (HS) commonly occurs around Hair follicles, where many oil and sweat glands are found, and where skin rubs together, such as:

  1. around the groin and genitals

  2. in the armpits

  3. near the anus

  4. on the buttocks and inner thighs

  5. under the breasts

The condition may also involve the nape of the neck, where the waistbands of pants and skirts sit and the inner thighs. HS Lesions have been known to occasionally appear on the front or back of the legs, on the sides of the torso, on the back or on the face.

ARE THERE OTHER ASSOCIATED CONDITIONS?

Though it affects the skin, hidradenitis suppurativa (HS) is an Inflammatory disease, which means people with the condition have irregularities in their Immune system. Immune system issues can increase the risk of other Inflammatory diseases – consequently there are several conditions associated with HS, including:

  1. Arthritis

  2. Crohn's disease

  3. Depression

  4. Malignancy

  5. Severe Acne

LIFESTYLE OPTIONS

For most people, regardless of having hidradenitis suppurativa (HS) or not, Exercise, healthy eating and good sleep habits are recommended. A healthy lifestyle can lead to enhanced quality of life for most people. Talk to your doctor before making any lifestyle changes.

Keep your skin cool

Your body overheating and sweating a lot can cause hidradenitis suppurativa (HS) Flares, so if at all possible try to stay away from hot, humid places.

If you need a product that can help reduce sweating, such as an antiperspirant, ask your Dermatologist for a recommendation. The ingredients in some antiperspirants are too harsh on skin affected by HS.

Maintain a healthy weight

It's unconfirmed whether hidradenitis suppurativa (HS) is more the cause of excess weight or an effect of it. So far it has conclusively been shown that people with HS are more often overweight compared to the General population. It seems the severity of HS symptoms usually increases in proportion to how overweight a person is, so getting the help and support needed to get to a healthier weight may be even more significant for people with HS.

Quit smoking

Though medical research has established a link between hidradenitis suppurativa (HS) and smoking, there is debate as to whether it tends to be smoking that leads to HS, or if it is HS (and associated conditions like Depression and a lack of Exercise) that makes people more likely to smoke. However, while quitting smoking will not cure your HS, it can definitely improve your overall health. It is also likely to reduce HS Flares and decrease its severity.

Be gentle with your skin

The following suggestions may help relieve soreness, speed up healing and prevent any already-formed Lesions from getting worse or spreading:

  • Avoid wearing perfume or perfumed deodorants in the places your skin gets lumpy and sore.

  • Stop shaving where you have breakouts, as it can irritate the skin. If you want to remove hair, ask your Dermatologist what you can safely use.

  • Make a habit of frequently and gently washing the places you have Flares with antiBacterial or antiseptic soap or shower gel. This will rid the skin of germs (bacteria). (Note: We all have harmless bacteria living on our skin. This is normal. Having too much bacteria is what we want to avoid – especially with HS.)

  • Consider the use of topical Antibiotics (applied directly to skin instead of taken orally) if the already formed Lesions become infected.

Choose your clothes wisely

Try to wear clothes that will reduce friction against the skin where you have recurrent Flares – for example, avoid tight waistbands and form-fitting clothes that rub against your skin. Opt for clothing such as boxer shorts, avoiding underwear or anything else with seams that rub where Lesions tend to appear. Also choose clothing that is cooling as well as loose so you don't overheat and sweat as much in those areas.

Relax to handle stress

Stress management methods may be useful because hidradenitis suppurativa (HS) can be more severe during times of increased stress. First identify your stress triggers, and then develop relaxation and coping skills that can improve your overall well-being and give you a greater sense of control over your HS and your life.

COMPLEMENTARY THERAPY OPTIONS

In many cases, treating hidradenitis suppurativa (HS) can be tricky. Many things may not work or offer the extent of relief patients and their healthcare teams hoped they would. Some treatments work well at some times but not as well at others. That's why some people with HS look to complementary and alternative therapies (treatments that fall outside the scope of traditional Western medicine). For some, these less common techniques and preparations may work well for relieving pain, and in clearing or reducing breakouts and preventing new ones. Ask your healthcare professional about alternative therapies – there are many you can try.

Temperature therapy

  • Wet a washcloth with very warm water and hold it as a compress over a problem area. This may reduce Swelling.

  • You can try holding a hot, wet washcloth (as hot as you can stand), against Boils to encourage the Pus to gather together under the skin so they may come to a head where the skin is thin enough to break and start draining. A boil that is leaking/draining hurts less than a hard Abscess full of Pus that cannot come out yet.

Surgery

You and your doctor may consider surgery if medical therapies are not working well enough for you. Long-standing, severe and persistent hidradenitis suppurativa (HS) often requires surgery at some point. The operation is usually performed under General anasthetic. Which kind of surgery is best for each individual with HS depends on how severe and how widespread the person's HS Lesions are.

There are several surgical options for HS. They include:

  • Incision and drainage. Surgical drainage may be an option when the HS Boils are in a single small area. During the surgery, the Dermatologist/surgeon will drain one or two or cut them out. This procedure is Generally for people with mild HS. Antibiotics are usually prescribed afterwards. This procedure can offer short-term relief but the HS symptoms may return.

  • Laser surgery. This treatment shows promise. Some patients' Lesions clear after several treatments. Lasers effectively clear new and deep HS breakouts. This treatment may be lasting in some people because it destroys the Hair follicle that so often become plugged.

  • Uncovering the tunnels. This procedure, also known as de-roofing, cuts away the skin and flesh that covers any interconnected tunnels linking separate Lesions. This opening up can increase healing of the Lesions and even minimize scarring. However, the disease may still return in the area treated or elsewhere on the body.

  • Surgical removal. Surgical treatment of recurrent or severe symptoms involves removal of all involved skin. A skin graft (skin removed from another part of your body) or a skin flap (nearby skin that is pulled over to cover the wound) may be necessary to close the wound. Full surgical removal of skin in an area prone to Boils and painful Lesions can prevent HS from coming back to the treated area, but it may still reappear in skin nearby.

  • Carbon dioxide laser. Depending on the severity of the disease (and where available), cutting lasers can be used as an alternative to conventional surgery. This innovative new technique is more suitable for people with moderate HS. A carbon dioxide laser vaporizes diseased Tissue from the surface of the skin, leaving an open wound, which is then left to heal. How long healing takes after the procedure depends on how large, deep and interconnected the treated Lesions were. Staying in the hospital overnight is not normally necessary after this kind of surgery.

Ask your doctor if a surgical option could be suitable for you.

MEDICAL TREATMENTS

There is no cure for hidradenitis suppurativa (HS) but early treatment can help manage the symptoms and may prevent new Lesions from developing.

The purpose of HS medical treatments is to:

  • Try to clear or reduce breakouts

  • Try to prevent scarring and tunnels beneath the skin

  • Try to prevent new breakouts

Treatments depend on the size of the affected areas and whether the sores are painful or become infected. Mild cases might be controlled and relieved with self-care measures like warm compresses and regular washings with antiBacterial soap, while moderate cases may require topical medications (those applied to the sore or damaged skin) and/or oral medications (those taken by mouth). It is important, however, to remember that each case of HS is as unique as the person who has it. The length and course of treatment(s) may be different for each individual.

No one treatment works for everyone who has HS. One may even work for a while and then stop working, so you will likely need to try a few different therapies or combinations before finding one that works well for you long-term. Your Dermatologist may include one or more of the following in your treatment plan and can explain the differences, benefits and side effects of each.

Please be sure to consult with your physician.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medications that can be used to treat the pain and inflammation of hidradenitis suppurativa (HS). NSAIDs do not control the disease, they only treat symptoms. That's why they can be taken daily or on an as-needed basis.

Antibiotics

Long-term use of Antibiotics may help prevent your HS symptoms from getting worse and lessen the chance of future Lesions breaking out. These drugs come in pill form or in creams or ointments to apply to skin affected by HS.

Corticosteroids

Cortisone and other steroids are something the body produces naturally to regulate inflammation. Because they work fast, doctors give Corticosteroids to patients with particularly severe and painful symptoms of hidradenitis suppurativa (HS). These drugs may reduce severe inflammatory Lesions. They provide the same kind of relief as NSAIDs, but are stronger, and are not meant to be relied upon for frequent symptom relief over the long term. Corticosteroids can have severe side effects, so they are usually taken for limited periods of time, often to relieve patients' severe symptoms while waiting for slower-acting medications to take effect.

Biologics

In moderate to severe cases of hidradenitis suppurativa (HS), the use of biologic response modifiers – or Biologics – have been proven to be effective. Biologics are medications specifically designed to target your body's Immune system – they work by decreasing the body's immune response.

Hormone therapy

Some women with hidradenitis suppurativa (HS) may get some symptom relief by taking birth control pills (also known as oral contraceptives), which regulate hormones. For a woman, "The Pill" may decrease the pain and the amount of fluid that drains from her breakout Lesions. Oral contraceptives may need to be taken for up to one year before seeing any improvement in HS symptoms.

Oral Retinoids

If your hidradenitis suppurativa (HS) doesn't respond to other treatments, your doctor may recommend using a drug from the Retinoid family. Vitamin A-based Retinoids have shown promising results in HS. It's not known exactly how Retinoids work, but they can stop the secretion of oils from glands and can help dead skin Cells shed normally in the Hair follicles, preventing the blockage of pores.

 

Source: Hidradenitis Suppurativa (HS) Foundation - www.hs-foundation.org

A localized collection of pus surrounded by inflamed tissue.
A disorder of the skin caused by inflammation of the skin glands and hair follicles; specifically, a form found mainly in adolescents and marked by pimples especially on the face.
A research study that compares the investigational drug or treatment to standard-of-care therapy (compared to placebo).
AIDS (acquired immunodeficiency syndrome) is the most advanced stage of infection with human immunodeficiency virus (HIV). HIV/AIDs can be spread through unprotected sex with an infected person or by sharing drug needles or through contact with the blood of an infected person.
A surgical connection made between two structures (usually tubular ones) such as blood vessels or loops of the bowel.
Male hormones used to control the production of estrogen.
A type of arthritis of the spine that causes inflammation between the vertebrae (bones that make up the spine) and in the joints between the spine and pelvis. In some people, ankylosing spondylitis can affect other joints.
Chemical substances that stop the growth of or kill bacteria, parasites and fungus. Antibiotics do not treat viral infections – antiviral drugs may treat some viruses.
Medications that block cholinergic neurotransmitter systems.
Apocrine glands are special sweat glands found in hairy areas of the body such as the armpits and groin.
The practice of using essential oils (generally plant-based) to improve health or a person’s mood.
The use of art that helps people manage physical and emotional problems by expressing themselves creatively.
A condition that causes pain and inflammation within a joint.
A rare childhood disease that affects the brain as well as other parts of the body.
Ophthalmic atropine may be used before eye examinations to dilate (open) the pupil (the black part of the eye). This medication can also be used to relieve pain caused by swelling and inflammation of the eye.
An illness that occurs when the body tissues are attacked by its own immune system. The immune system is designed to “seek and destroy” disease in the body, including infectious agents. Patients with autoimmune diseases frequently have unusual antibodies circulating in their blood that target their own body tissues.
In a a trial protocol, an explanation of what is known so far about the medical product being studied.
Relating to or caused by bacteria. Often used to describe the origin of an infection.
A disease involving inflammation of the blood vessels; it may affect many parts of the body.
An antibacterial ingredient often used in acne medications. It is a flammable white granular solid used as a bleaching agent for flour, fats, waxes and oils, and in pharmaceuticals.
When a point of view prevents objective judgment on issues relating to the patient. In clinical studies, bias is controlled through blinding and randomization.
A yellow or greenish liquid made by the liver that helps the body digest fats.
Therapy involving natural or manufactured substances that change the way cells behave. Biological therapies can cause certain cells to stop growing, block the release of hormones or strengthen the body’s immune system.
The removal of samples of tissue, cells or fluids from the living body. Biopsies can be taken using a biopsy instrument that is passed through the skin or through an endoscope into the organ in question, or is collect by open surgery. A trained specialist (pathologist) examines the tissue under a microscope to establish a precise diagnosis such as cancer.
A clinical trial is called blinded or “masked” when patients don’t know whether they are in the experimental or control arm of the study.
An anticoagulant agent used to prevent blood clots. In heart or blood vessel disease, or poor blood flow to your brain, doctors may recommend a blood thinner. Blood thinners can decrease the risk of heart attack and stroke by reducing the formation of blood clots in arteries and veins.
A localized swelling and inflammation of the skin usually resulting from bacterial infection of a hair follicle and adjacent tissue, having a hard central core, and forming pus.
A bone scan is a procedure that checks for abnormal areas or damage in the bones. Prior to the scan, a very small amount of radioactive material is injected into a vein. This collects in the bones and is detected by a scanner (a special camera that takes pictures of the inside of the body).
Another name for the intestines: the small bowel (duodenum, jejunum and ileum), and the large bowel (colon and rectum).
BRCA 1 is a gene on the human chromosome 17 and BRCA 2 is a gene on chromosome 13. These genes normally help to control cell growth. A person who inherits certain mutations (changes) in one or both of these genes has a higher risk of getting breast, ovarian, prostate, and other types of cancer.
Medication used to block an enzyme responsible for breaking down levodopa before it reaches the brain; carbidopa is always given in combination with levodopa
A cancer that starts in the skin or in tissues that line or cover internal organs.
A strong but flexible, somewhat elastic tissue found in some parts of the body (such as the nose, the outer ear, and some joints).
A clouding of the lens in the eye which may affect vision. Cataracts commonly occur in older people.
A non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, tenderness, swelling and stiffness associated with osteoarthritis (arthritis due to a breakdown of the lining of the joints), rheumatoid arthritis, and ankylosing spondylitis.
The basic building blocks of the body's tissues. The human body is made up of many different types of cells. Human cells vary in size, but all can only be seen with a microscope.
Aclear, colorless body fluid found in the brain and spine that acts as a cushion or buffer for the brain's cortex, providing basic mechanical and immunological protection to the brain inside the skull. It also constitutes the content of the ventricles, cisterns, and sulci of the brain, as well as the central canal of the spinal cord.
The layer of blood vessels and connective tissue that rests between the white of the eye and retina (at the back of the eye). The choroid is part of the uvea and supplies nutrients to the inner parts of the eye.
Persisting over a long period of time. Relating to disease, one that is slow in progressing and long lasting.
A structure in the eye that releases a transparent liquid (aqueous humor) inside the eye.
A medical condition in which hard scar tissue largely replaces soft, healthy tissue in the liver. Severe scarring of the liver can prevent it from functioning well. It is important to know that cirrhosis is the end result of many kinds of injury to the liver, such as alcohol, hepatitis C, autoimmune liver disease and others (alone or in combination). Therefore, any chronic liver disease that is severe and progressive can result in cirrhosis.
Eye disease with symptoms that include blind spots, blurred vision and other vision problems as well as floaters. Most people are exposed to CMV in their lifetime but typically only those with weakened immune systems become ill from CMV infection.
Can spread from one person or organism to another by direct or indirect contact.
Corticosteroids are a group of natural and synthetic analogs of the hormones secreted by the pituitary gland. They are prescribed on a short-term basis as fast-working medication for particularly severe and painful symptoms.
Corticosteroids are a group of natural and synthetic analogs of the hormones secreted by the pituitary gland. They are prescribed on a short-term basis as fast-working medication for particularly severe and painful symptoms.
Also known as Cowden disease, involves a mutation in the tumor suppressor gene phosphatase and tensin homolog (PTEN).
A type of inflammatory bowel disease that causes irritation of the digestive, or gastrointestinal (GI) tract.
Treatments used to diminish some side effects of cancer treatments, particularly bone marrow suppression. CSFs stimulate the bone marrow so that it increases its production of blood cells. With more blood cells the risk of infection, anemia and bleeding is reduced.
Also known as intermediate uveitis, it affects the ciliary body.
A medication used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer that occurs mainly in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin). Cyclophosphamide belongs to a group of cancer medicines called alkylating agents.
A noncancerous, closed pocket of tissue that can be filled with fluid, pus, or other substance. Cysts feel like large peas under the surface of the skin.
Inflammation of an entire digit (a finger or toe), which can sometimes be painful. Dactylitis can occur in psoriatic arthritis and ankylosing spondylitis.
A medical condition that causes a persistent feeling of sadness, loss of interest, and hopelessness.
A dermatologist is a medical doctor specializing in the skin, the diseases of the skin, and the relationship of skin lesions to overall disease.
If a person has diabetes, their body is not able to properly use the sugar that is released from the food they eat. These sugars build up in the body and can make them feel nauseated, very hungry, very thirsty or very sick, with frequent urination.
Diagnostic examination used to x-ray the breast in patients who have signs or symptoms of disease, such as pain, a lump or nipple discharge. Doctors may use diagnostic mammography to look for tumors or other abnormalities.
A neurotransmitter that regulates movement and emotions.
Medications that work in a similar way to dopamine.
Ductography is an x-ray of the breast ducts (tubes that carry milk from the lobules to the nipple).
The point at which a tendon or ligament or muscle inserts into bone, where the collagen fibers are mineralized and integrated into bone tissue. Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone, points where recurring stress or inflammatory autoimmune disease can cause inflammation or occasionally fibrosis and calcification. One of the primary entheses involved in inflammatory autoimmune disease is at the heel, particularly the Achilles tendon.
A chemical substance in animals and plants that aids natural biological processes (such as digestion).
Estrogen is a hormone made by the body that helps develop and maintain female sex characteristics and plays a role in the growth of long bones. Estrogen can also be made in the laboratory. Estrogen may be used for birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
An estrogen receptor is a protein found inside the cells of the female reproductive tissue, some other types of tissue, as well as some cancer cells. The hormone estrogen will bind (attach to) the receptors inside the cells and may cause the cells to grow.
Activity requiring physical effort, carried out especially to sustain or improve health and fitness.
Extreme tiredness, exhaustion that doesn’t get better with rest.
An episode when the symptoms of a disease or condition break out or intensify rapidly, become suddenly worse or more painful.
Small spots occasionally seen in the field of vision. Floaters may appear as dots, threads or cobwebs.
A doctor who specializes in the study of digestive organs including the liver.
Carries the information inside each cell of the body that determines biological traits, which are features or characteristics that are passed on by parents.
Relating to, caused by, or controlled by genes.
The genetic makeup of an organism or group of organisms with reference to a single trait, set of traits, or an entire complex of traits; the sum total of genes transmitted from parent to offspring.
A group of diseases associated with damage the eye's optic nerve. Glaucoma occurs when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Without treatment, people with glaucoma may slowly lose their peripheral (side vision). Over time, blindness may result.
A sugar occurring in many fruits, animal tissues and fluids, etc., and having a sweetness about half that of ordinary sugar.
The GCP defines international quality standards that governments can incorporate into regulations for clinical trials involving human subjects. Good Clinical Practice guidelines include standards on how clinical trials should be conducted. These also define the roles and responsibilities of clinical trial sponsors, investigators, and monitors. Monitors are hired by the sponsor to verify that the data/information at the site (hospital, clinic) is accurate.
A deep narrow pit that is formed by the tubular infolding of the epidermis and that encloses the root of the hair and into which oil glands often secrete.
Hemodialysis is a process where a machine filters wastes, salts and fluid from the blood when the kidneys are no longer healthy enough to do this on their own.
A liver disease caused by the hepatitis A virus (HAV). HAV causes the liver to swell and prevents it from working well. HAV is passed from person to person through fecal matter. Most often it is transmitted because of poor hand-washing after using the bathroom or changing a diaper, or before preparing and eating food. Unlike Hepatitis B and hepatitis C, it does not become chronic (long-term).
A liver disease caused by the hepatitis B virus (HBV). HBV causes the liver to swell and prevents it from working well. HBV is passed from person to person through bodily fluids such as blood, semen or vaginal secretions. Most often it is transmitted through sexual contact or from an infected mother to her infant during birth.
A doctor who specializes in the study of the liver.
HER2 is a type of protien(made with instructions from the HER2 gene) that helps to control cell growth. When the HER2 protein is made in larger than normal amounts by cancer cells, the cells may grow more quickly and can spread to other parts of the body.
There are two approved forms of testing that utilizes a biopsy of breast tissue and/or breast tumor cells to observe either how much of the HER2 protein is present in the tumor or how many copies of the HER2 gene that instruct the rapid development of that protein are present.The tests look for abnormal amounts of each and the results can help inform treatment options.
A virus that affects the skin or the nervous system, often causing blisters.
A condition that occurs when too much hair to grow on a woman’s face or body.
A disease caused by a fungus called Histoplasma. This fungus grows in soil and material contaminated with bat or bird droppings. Breathing the fungal spores can cause infection; it is not contagious between people.
HIV (short for human immunodeficiency virus) weakens the immune system by destroying important cells that fight disease and infection. A deficient immune system can’t protect from illness as it normally would. It is sometimes referred to as the AIDS virus.
Tests that measure the amount of certain proteins, called hormone receptors, in cancer tissue. Hormones can attach to these receptors. Having a lot of hormone receptors means that hormones can help the cancer grow.
Hormones (estrogen, progesterone, or both) are used to treat women after menopause to replace the hormones no longer produced by the ovaries.
A surgical operation for ulcerative colitis (UC) after removal of the bowel. An internal pouch is made from the ileum and attached to the anus. This means stools are passed through the anus in the usual way. Sometimes referred to as restorative proctocolectomy.
The network of cells, tissues and organs that work together to protect the body and defend it against infectious organisms (bacteria, viruses, etc.) and other harmful substances. Through a series of steps called the immune response, the immune system attacks these organisms and substances.
Suppression of the immune system and its ability to fight infection. Immunosuppression may be due to drugs or diseases.
Infections are caused by germs inside the body. Different types of infections include colds, sore throats, rashes, and cuts or wounds that become infected. How they are treated depends on what type of germ caused the infection.
A term to describe disease that can be transmitted through the environment, and can spread infection.
A natural process that the body normally uses to protect itself from harm, such as an injury or infection. Affected areas may become red, swollen and painful and feel hot or warm to the touch.
A type of breast cancer that begins in the breast ducts. The cancer cells spread from the ducts to the lymph vessels in the skin of the breast.
A disease characterized by inflammation, where the body’s immune system thinks its own cells are threats, attacking them as they would typically target external threats like foreign bacteria or a virus.
See PRINCIPAL INVESTIGATOR.
Ionizing radiation is made (or given off) by X-ray procedures, radioactive substances, rays that enter the Earth's atmosphere from outer space, as well as other sources. At high doses, ionizing radiation increases the chemical activity inside cells and can lead to health problems, such as cancer.
The colored portion of the eye containing a circular opening, the pupil, in its center.
A condition involving inflammation of the eye's iris. The iris is a part of the middle layer of the eye (uvea), so iritis is sometimes called anterior uveitis.
Yellowing of the skin and the whites of the eyes. It is caused by accumulation of bilirubin in the body when the liver is not working well.
The point of contact between elements of a skeleton whether movable or rigidly fixed together with the surrounding and supporting parts (as membranes, tendons or ligaments).
A rare childhood disease that makes the walls of the blood vessels in the body become inflamed; this disease can affect any type of blood vessel, including the arteries, veins and capillaries.
Kinesiologists are medical specialists who are leaders in the prevention and management of injury and chronic disease through movement. Using exercise, they are devoted to improving performance, health and overall quality of life.
An abnormal change in structure of an organ or body part due to injury or disease.
A hereditary cancer predisposition syndrome reported in 1969 by Drs. Frederick Li and Joseph Fraumeni from the National Cancer Institute.
The tough bands of tissue that serves to connect the articular extremities of bones or to support or keep an organ in place. Ligaments are usually composed of coarse bundles of dense white fibrous tissue parallel or closely interlaced – they are pliant and flexible, but not extensible.
The growth and spread of unhealthy cells in the liver. Also known as hepatocellular carcinoma.
A liver transplant is the process of replacing a diseased liver with a donated, healthy liver.
A reaction that looks like Lupus, defined as an inflammatory connective tissue disease often held to be an autoimmune disease. Occurring chiefly in women, Lupus is characterized by fever, skin rash and arthritis, often by acute hemolytic anemia, and by small hemorrhages in the skin and mucous membranes.
A lymph node is a rounded mass of lymphatic tissue surrounded by a capsule of connective tissue. Located in the lymphatic system, these nodes filter lymph (lymphatic fluid), and they store white blood cells. Lymph is a clear fluid that carries cells that help fight infections and other diseases. The lymphatic system is made up of the tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. Lymphatic vessels extend to all tissues of the body.
A cancer of a part of the immune system known as the lymph system.
An MRI is a procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of the body’s interior. These pictures can distinguish between normal and diseased tissue.
Malignant is the description of a type of tumor that can invade and destroy tissues and spread to other parts of the body.
When cancer cells spread (metastasize) from one part of the body to another where they can grow into new tumors.
An approach based on the belief that the body can be stimulated to heal itself.
Chemical (such as dopamine, acetylcholine, or norepinephrine) which transmits or relays information or signals from one nerve cell (neuron) to other nerve cells or muscle cells.
A lymph node is a rounded mass of lymphatic tissue surrounded by a capsule of connective tissue. Located in the lymphatic system, these nodes filter lymph (lymphatic fluid), and they store white blood cells. Lymph is a clear fluid that carries cells that help fight infections and other diseases. The lymphatic system is made up of the tissues and organs that produce, store and carry white blood cells that fight infections and other diseases. Lymphatic vessels extend to all tissues of the body.
A small mass of rounded or irregular shape.
See OBSERVATIONAL MODEL and OBSERVATIONAL STUDY
The general design and strategy as to identifying and following up with participants during observational research studies. Types of observational study models include cohort, case-control, case-only, case-crossover, ecologic or community studies and family-based.
A research study whereby patients identified as belonging to study groups are assessed for biomedical or health outcomes. Patients may receive diagnostic, therapeutic, or other types of treatments, but the investigator does not assign participants to specific interventions (as in an interventional study).
A doctor who specializes in treating patients with cancer.
A medical doctor specializing in the branch of medical science dealing with the anatomy, functions and diseases of the eye.
A licensed professional who examines the eyes (using suitable instruments or appliances) for defects in vision and eye disorders in order to prescribe corrective lenses or other appropriate treatment.
The bones of a person with osteoporosis are weak and more likely to break. Anyone can develop osteoporosis; however, it is common in older women.
In biology, “overexpression” means to make too many copies of a protein or other substance. Overexpression of certain proteins or other substances can play a role in cancer development.
A rare form of breast cancer that begins in the breast ducts and spreads to the skin of the nipple and areola. The affected skin may appear to be crusted, scaly, red, or oozing.
A condition that occurs when all layers of the uvea are inflamed.
People with this condition have a mutation in the STK11 (also called LKB1) tumor suppressor gene.
The processes (in a living organism) of absorption, distribution (in the body), metabolism (process by which the body breaks down and converts medication into active chemical substances to treat a disease), and excretion of a drug or vaccine (usually via feces, urine and even respiration).
An inactive pill, liquid, or powder that has no treatment value. In clinical trials, experimental treatments are often compared with placebos to assess the treatment's effectiveness.
The study method whereby an inactive substance (the placebo) is given to one group of patients while another group receives the drug being tested. The results are then compared to see if the test treatment is more effective than the placebo in treating the condition.
Inflammation of the ileal pouch (an artificial rectum surgically created out of ileal gastrointestinal tissue in patients who have undergone a colectomy).
In drug and medical product/device development, a study that is classified as “preclinical” means it is at the stage of research where it has yet to be cleared for testing in humans and is still being tested in animals to gather important feasibility, and drug safety data.
The clinical trial doctor - a highly qualified physician who carries out the research and interacts with the patients. All clinical trial doctors also have additional training in clinical trials and research.
Progesterone is a hormone made by the body that plays a role in the menstrual cycle and pregnancy. The hormone progesterone can also be made in the laboratory. It is used for birth control and as a treatment for menstrual disorders, infertility, symptoms of menopause, and other conditions.
A protein found inside the cells of the female reproductive tissue, some other types of tissue, as well as some cancer cells. The hormone progesterone will bind (attaches) to the receptors inside the cells and may cause the cells to grow.
The probable outcome or course of a disease; can also refer to the chance of recovery or recurrence.
A Protocol is the study plan on which the clinical trial is based. All plans are carefully designed to safeguard the volunteers, as well as answer specific research questions. A protocol describes who may participate in the clinical trial, the schedule of tests, procedures, medications, and regular follow-ups by the principal investigator and team to monitor the health and safety of research study participants, and effectiveness of the treatment.
Thick, yellowish-white fluid formed at the site of inflammation during infection.
A treatment that uses high-energy particles or waves to destroy cancer cells.
A clinical trial method in which the subjects are randomly distributed into groups which are either given the test drug or which serve as the control group.
Often expressed in terms of a number that confirms that the act of randomization – subjects being assigned by chance into separate groups that are then used to compare different treatments—has occurred. The number is indicative of the total number of times this process has successfully taken place. There is often a total number of randomized subjects that is the goal for a study to meet in order to be considered complete.
In a clinical trial protocol the rationale is the reason why a clinical trial is being conducted.
Reactive arthritis is a type of arthritis, or joint inflammation that occurs as a “reaction” to an infection somewhere else in the body.
The last part of the colon.
Recurrence means cancer that has recurred or come back. This usually happens after a period of time during which the cancer could not be detected. The cancer recur in the same place as the original (primary) tumor or to another place in the body.
A period free of active disease with few or no symptoms.
Carefully planned studies (also called a clinical trial or clinical study) that observe or treat patients in order to develop or discover new treatments or medications. Researchers want to see how well a drug works, how it can be used safely, and learn how to prevent, screen for, better diagnose and treat health issues
When the retina has been lifted or pulled from its normal position. It can occur at any age, but is more likely in people over age 40.
Any of various synthetic or naturally occurring analogs of vitamin A.
A form of arthritis that causes pain, swelling, stiffness and loss of function in the joints. It can affect any joint but is common in the wrist and fingers.
A disease involving inflammation, usually in the lungs, skin or lymph nodes. Sarcoidosis starts as tiny, grain-like lumps, called granulomas and can affect any organ in the body.
A type of breast imaging test used to detect cancer cells in the breasts of some individuals who have already had abnormal mammograms or who have dense breast tissue. This is not used for screening or in place of a mammogram.
The first visit to the site of a clinical trial, that evaluates whether the person can participate or not. The volunteer meets the specialist and study coordinator, reviews the informed consent form, undergoes a physical exam and tests, reviews their medical history, etc. If they qualify, a baseline visit is scheduled.
A hormone, such as estrogen or testosterone, affecting sexual development or reproduction.
A narrow, elongated channel in the body that allows the escape of fluid.
The backbone. Vertebrae are any of the bony or cartilaginous segments that make up the spinal column.
A means of describing or classifying cancer based on the extent of the cancer in the body.
To destroy microorganisms which adhere to surfaces, usually by bringing objects to a high temperature with steam, dry heat, or boiling liquid.
Its the sensation of dfficulty in moving a joint or apparant loss of range of motion of a joint.
The investigative methods found in the protocol that are used in a clinical trial.
see PLACEBO
A doctor who manages the treatment of cancer by excision (surgery).
A tubular gland of the skin that excretes perspiration.
Abnormal enlargement of a body part, typically due to an accumulation of fluid.
A sexually transmitted disease that can affect the genital area, lips, mouth, or anus of both men and women. Syphilis can be transmitted from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.
A group of cells that work together to carry out a specific function.
Toxoplasmosis is a disease caused by the parasite Toxoplasma gondii. The infection can cause damage to the brain, eyes, and other organs.
Traditional Chinese medicine is based on the belief that disease is caused by problems with the flow of energy in the body. Herbal remedies as well as other procedures such as acupuncture and massage are used to restore the flow of energy in the body.
The act of transfusing donated blood, blood products or other fluid into the circulatory system of a person or animal.
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
Can also be called a neoplasm. A tumor is an abnormal mass of tissue that occurs when cells divide more than healthy cells or do not die when they are supposed to. Tumors can be benign ( non cancerous), or malignant (cancerous).
Diabetes means a person’s blood sugar (glucose) level is too high. Type 2 diabetes, the more common type, means the body does not make or use the hormone insulin properly. Insulin helps glucose get into the cells to give them energy. Without insulin, too much glucose stays in the blood, and over time this can lead to serious problems of the heart, eyes, kidneys, nerves, and gums and teeth.
An ulcer is an area of tissue erosion (loss of surface tissue), for example, of the lining of the gastrointestinal (GI) tract or skin. Due to the erosion, an ulcer is concave like a crater and depressed below the level of the surrounding tissue.
A procedure that uses high-energy sound waves to look at tissues and organs inside the body. These sound waves make echoes that form images of the tissues and organs on a computer screen (sonogram). Ultrasound can be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures.
Inflammation of the uvea, the pigmented, vascular structure in the eye consisting of the iris, ciliary body, and choroid.
A substance that is usually injected into a person or animal to protect against a particular disease.
The amount of a virus(such as hepatitis B or hepatitis C virus) in the blood.
An extremely small living thing that causes a disease and that spreads from one person or animal to another. It can only reproduce itself by taking over a cell in the body of its host.
A disease associated with chronic inflammation of melanocytes (specialized cells that produce a pigment called melanin). Melanin gives skin, hair, and eyes their color.
A disease spread by infected mosquitoes. Although many infected people experience no symptoms, the infection may be associated with fever, headache, body aches, skin rash, and swollen lymph glands. These symptoms can last a few days to several weeks, and usually go away on their own. If West Nile virus enters the brain, it can be life-threatening.

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