Fatal case of hidradenitis suppurativa described

(HealthDay)—Hidradenitis suppurativa (HS) can be associated with infectious and/or neoplastic fatal complications, according to a case report published online Oct. 16 in the International Journal of Dermatology.

Alice Verdelli, M.D., from the University of Florence in Italy, and colleagues reported the case of a 78-year-old man with a 25-year history of HS involving the gluteal and intergluteal regions. The patient had undergone numerous treatments and minor surgical procedures, but the HS always recurred and had worsened over the five years preceding the current presentation.

The researchers observed multiple nodules, abscesses, draining fistulas, and fibrotic scar tissue affecting the gluteal and intergluteal region on physical examination. Intense pain, functional impotence, and inability to walk were associated with the lesions. Infliximab was started as an off-label treatment with the patient's agreement. The active lesions had improved after five months and had resolved at 10 months, at which point infliximab was discontinued. Three months later, the patient developed fever and other symptoms together with reactivation of HS lesions and was hospitalized with a diagnosis of sepsis due to Acinetobacter baumannii. An ulcerative lesion developed and enlarged within five weeks; a biopsy showed a moderately differentiated squamous cell carcinoma. The patient died despite systematic antibiotic treatment.

"In conclusion, our report highlights that HS can have infectious and/or neoplastic fatal complications," the authors write.