CLINICAL IMAGE
A severe case of hidradenitis suppurativa Vanessa Cubas & David McArthur Heartlands Hospital, Heart of England Foundation Trust, Birmingham B9 5SS, UK
Correspondence Vanessa Paola Cubas, Heartlands Hospital, Heart of England Foundation Trust, Birmingham B9 5SS, UK. Tel: +07729456671; E-mail: [email protected] Funding Information No sources of funding were declared for this study. Received: 5 November 2015; Accepted: 26 March 2016
Key Clinical Message Hidradenitis suppurativa (HS) is a chronic disfiguring skin disease affecting apocrine sweat glands, characterized by abscesses, cysts, or infections. There is currently no cure or a consistently effective treatment. HS is a challenging condition to diagnose and treat. We present a severe case to raise awareness of this disabling condition. Keywords Abscess, dermatology, general surgery, health maintenance.
Clinical Case Reports 2016; 4(6): 614–615 doi: 10.1002/ccr3.564
Clinical Image Description Patient presented with swellings involving the groin, axillae, chest, and intergluteal area. He was treated with antibiotics and incision and drainage of abscesses. Following many investigations including MRI, immunological, and microbial studies, a severe case of hidradenitis suppurativa was diagnosed following biopsy. He is currently under consideration for plastic reconstruction (Figs. 1–3).
Figure 1. Hidradenitis suppurativa affecting the patient in the axillae and chest.
614
Hidradenitis suppurativa is a chronic disfiguring skin disease affecting areas bearing apocrine sweat glands, characterized by chronic abscesses; epidermoid, sebaceous, or pilonidal cysts; or multiloculated infections. It usually goes undiagnosed due to a delay in seeking treatment and is frequently misdiagnosed. There is currently no known cure or a consistently effective treatment. Traditionally, it has been attributed to the occlusion of the apocrine duct by a keratinous plug. As a result, the cysts can be extremely tender and persist for years with
Figure 2. Close up of the condition affecting the chest.
ª 2016 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
V. P. Cubas & D. McArthur
Hidradenitis suppurative
intermittent periods of inflammation, which may need incision and drainage of pus. This process often leads to open wounds with healing problems, sinus tract formation, and chronic scarring. Other sequelae include cellulitis and depression.
Conflict of Interest None declared.
Figure 3. Close up of the condition affecting the axilla.
ª 2016 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
615
A severe case of hidradenitis suppurativa Vanessa Cubas & David McArthur Heartlands Hospital, Heart of England Foundation Trust, Birmingham B9 5SS, UK
Correspondence Vanessa Paola Cubas, Heartlands Hospital, Heart of England Foundation Trust, Birmingham B9 5SS, UK. Tel: +07729456671; E-mail: [email protected] Funding Information No sources of funding were declared for this study. Received: 5 November 2015; Accepted: 26 March 2016
Key Clinical Message Hidradenitis suppurativa (HS) is a chronic disfiguring skin disease affecting apocrine sweat glands, characterized by abscesses, cysts, or infections. There is currently no cure or a consistently effective treatment. HS is a challenging condition to diagnose and treat. We present a severe case to raise awareness of this disabling condition. Keywords Abscess, dermatology, general surgery, health maintenance.
Clinical Case Reports 2016; 4(6): 614–615 doi: 10.1002/ccr3.564
Clinical Image Description Patient presented with swellings involving the groin, axillae, chest, and intergluteal area. He was treated with antibiotics and incision and drainage of abscesses. Following many investigations including MRI, immunological, and microbial studies, a severe case of hidradenitis suppurativa was diagnosed following biopsy. He is currently under consideration for plastic reconstruction (Figs. 1–3).
Figure 1. Hidradenitis suppurativa affecting the patient in the axillae and chest.
614
Hidradenitis suppurativa is a chronic disfiguring skin disease affecting areas bearing apocrine sweat glands, characterized by chronic abscesses; epidermoid, sebaceous, or pilonidal cysts; or multiloculated infections. It usually goes undiagnosed due to a delay in seeking treatment and is frequently misdiagnosed. There is currently no known cure or a consistently effective treatment. Traditionally, it has been attributed to the occlusion of the apocrine duct by a keratinous plug. As a result, the cysts can be extremely tender and persist for years with
Figure 2. Close up of the condition affecting the chest.
ª 2016 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
V. P. Cubas & D. McArthur
Hidradenitis suppurative
intermittent periods of inflammation, which may need incision and drainage of pus. This process often leads to open wounds with healing problems, sinus tract formation, and chronic scarring. Other sequelae include cellulitis and depression.
Conflict of Interest None declared.
Figure 3. Close up of the condition affecting the axilla.
ª 2016 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
615
