Hidradenitis suppurativa

QUESTION 19

A 37-year-old African American woman with a history of depression presents with multiple recurrent abscesses in both axillae and in her inguinal region, many of which have required multiple visits to the emergency department for incision and drainage and multiple repeated courses of oral antibiotics. She states that they began occurring in her 20s and her sister also develops similar lesions. They have now increased in frequency and she is concerned about the scarring and pigmentation changes that the lesions leave behind. On examination, there are subcutaneous hyperpigmented nodules with associated firm scarring tracts, some with white-yellow drainage (19). There are multiple double comedones within the axillae and groin folds.