
Suffering From Hidradenitis, Diabetes And Ketoacidosis. Uncontrollable Sugar Levels, Repeated Boils. Antibiotics Not Working

What I can gather from the details you have provided is that your daughter is suffering from type 1 diabetes and she is having repeated episodes of Hidradenitis suppurativa(HS) of axilla.You have not mentioned the age of your child and the tpe of medications or insulin she is on for diabetes. I have to confess that this condition is pretty complicated and may also be resistant to treatment.
There are some triggering factors for HS which you have to be aware of-like tight clothing,obesity, excessive sweating,application of deodorants and cosmetics, hot humid conditions and some drugs. There are some genetic factors predisposing to the condition and some times it can have an autoimmuune basis also. So detailed evaluation of the possible predisposing factors is mandatory. Presence of diabetes complicates the picture as infection becomes difficult to control in them. Your daughter needs to be on insulin and blood sugars will have to be kept below 200 unless she is very young.
Some lifestyle modifications can help- changes in diet avoiding refined carbohydrates, use of hydrotherapy, weight loss, warm compresses and maintaining good hygiene.
What we follow in our practice when the process becomes chronic and treatment resistant is wide surgical excision with removal of entire apocrine gland complex followed by an split skin grafting.
Management requires mutispeciality care including an endocrinologist, dermatologist, plastic surgeon and a physician who has expertise in infectious diseases and immunology. So I think you need to visit a tertiary care multispeciality referral centre and consult these specialists.


I tend to think that the stress this puts upon her is what is making it worse. Also, I was recently diagnosed with Spondyloarthritis which involves an arthritis gene HLA-B27. Do you think it could be related and should I have her tested for that? She had similar boils under her arms when she was about 14 or so. I am sure the diabetes contributes but is not a cause of unless it was triggered when she went into the diabetic coma (she was diagnosed two years ago). We are desparate for suggestions. Should she see an endocrinologist? The infection specialists basically said that there is nothing to do but keep treating the infections.
She needs to be tested for autoimmune disorders, HLA B27 is one of them. HS could be related to autoimmune disorders - we have to test for them to confirm it. management will also change if it is related to autoimmune condition. She needs to be seen by an Endocrinologist. You need to discuss with him in detail regarding your concerns. Since you have tried almost everything I think now a more focused and aggressive multispeciality approach is required. Blood glucose levels will have to be brought down to lower levels.
Regards,



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