EclaireMD Foundation, USA

Abstract

Hidradenitis Suppurativa (HS) is a relatively common chronic debilitating skin condition characterized by recurrent abscessesand sinuses formation on apocrine sweat glands bearing areas. Although immune modulating therapies have beenpopular lately but definitive surgery with wide excision and reconstruction can provide permanent cure for the involvedareas. Here we are reporting an unfortunate case of a 47 years old male who has been suffering from HS in the buttocks andperineum since adolescence. Patient was first seen 8 years back and he was advised to consider wide surgical excision and skin grafting. Patient did not accept this solution and kept undergoing alternative treatments with prolonged courses ofantibiotics as well as steroids. Eventually he presented with fungating areas in the gluteal region which proved to be moderatelydifferentiated squamous cell was carcinoma (SCC). Sacrum was already invaded with the disease and has metastasized toregional lymph nodes, liver and lungs. Patient was treated as palliative including conservative surgical debulking and skingrafts. He received further oncologic treatment in a different center overseas. Unfortunately developed brain metastasisand expired two years following diagnosis of Marjolin’s ulcer (MU). Patients with chronic HS, recurrant infections andsinuses must be encouraged to seriously consider definitive surgical treatment to eliminate the risk of such long term fatalcomplication of their disease.