What is the cause of recurrent red, sore bumps under the breasts, in the panniculus (pannis), and axillae (arm pits) in a 30-year-old female?

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Differential Diagnosis for Red, Sore Bumps

Single Most Likely Diagnosis

  • Hidradenitis Suppurativa (HS): This condition is characterized by recurring, painful bumps or abscesses in areas where skin folds occur, such as under the breasts, in the armpits, and in the groin area. The symptoms described match closely with HS, making it the most likely diagnosis.

Other Likely Diagnoses

  • Folliculitis: An inflammation of the hair follicles, which can cause red, sore bumps, especially in areas prone to sweating and friction like the armpits and under the breasts.
  • Intertrigo: A skin infection that occurs in warm, moist areas of the body, such as skin folds, leading to redness, soreness, and sometimes bumps or blisters.
  • Eczema (Dermatitis): Can cause red, itchy, and sore skin, potentially leading to bumps, especially if infected or if the skin is scratched.

Do Not Miss Diagnoses

  • Breast Cancer: Although rare, inflammatory breast cancer can cause redness, swelling, and soreness under the breasts, which might initially be mistaken for a skin condition.
  • Lymphoma: Certain types of lymphoma can cause lymph nodes to become swollen and painful, potentially feeling like sore bumps in the armpits or other areas.
  • Tuberculosis: Can cause skin lesions or bumps, especially in immunocompromised individuals, and is crucial not to miss due to its serious implications.

Rare Diagnoses

  • Apocrine Gland Cysts: These are rare cysts that can form in the apocrine glands, found primarily in the armpits and groin area, and can become infected, leading to painful bumps.
  • Fox-Fordyce Disease: A rare skin condition that causes itchy, dome-shaped bumps in the armpits, groin, and under the breasts, due to the blockage of apocrine sweat glands.
  • Sweat Gland Abscesses: Although less common, abscesses can form in the sweat glands, leading to painful, sore bumps, particularly in areas prone to sweating.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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