Coalescing Tender Nodules on the Anterior Chest: An Atypical Presentation of Hidradenitis Suppurativa
Main Article Content
Keywords
hidradenitis suppurativa, acne inversa, follicular occlusion
Abstract
Hidradenitis suppurativa (HS) is an inflammatory skin condition that is characterized by inflamed nodules and abscesses that can form sinus tracts under the skin, typically in skin fold areas, that are tender and drain pus. Efficient diagnosis and early intervention is critical for this condition, as initiating treatment can keep the lesions under control and prevent worsening of nodules that can cause significant discomfort and permanent scarring. Here, we present a case of an unusual presentation of hidradenitis suppurativa in a 41-year-old male who presented to the emergency department with a chief complaint of a tender, purulent anterior chest cutaneous mass, which pathology later confirmed was consistent with an HS lesion. While HS typically occurs in regions with skin folds, this case illuminates an atypical presenting area – the anterior chest wall. Thus, clinicians should keep HS on the differential for such lesions, as the location of the affected area should not rule in or out HS as a diagnosis.
References
2. Revuz J. Hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2009;23:985-98.
3. Wiseman MC. Hidradenitis suppurativa: a review. Dermatol Ther. 2004;17:50-4.
4. Naasan H, Affleck A. Atypical hidradenitis suppurativa. Clin Exp Dermatol. 2015;40:891-3.
5. Baughman SM, Cespedes RD. Unusual presentation of hidradenitis suppurativa with massive enlargement of penis. Urology. 2004;64:377-8.
6. Chaikin DC, Volz LR, Broderick G. An unusual presentation of hidradenitis suppurativa: case report and review of the literature. Urology. 1994;44:606-8.
7. Fisher S, Ziv M. Ectopic presentation of hidradenitis suppurativa. Clin Dermatol. 2023;41:592-600.
8. Konety BR, Cooper T, Flood HD, Futrell JW. Scrotal elephantiasis associated with hidradenitis suppurativa. Plast Reconstr Surg. 1996;97:1243-5.
9. Syed ZU, Hamzavi IH. Atypical hidradenitis suppurativa involving the posterior neck and occiput. Arch Dermatol. 2011;147:1343-4.
10. Andersen RK, Jemec GB. Treatments for hidradenitis suppurativa. Clin Dermatol. 2017;35:218-224.