From chronic hidradenitis suppurativa to epidermoid carcinoma, from inflammation to cellular degeneration

TL;DR

This paper reports a rare case of a skin disease turning into cancer, highlighting the importance of early diagnosis and treatment.

Contribution

The paper presents a clinical case showing malignant transformation of hidradenitis suppurativa into squamous cell carcinoma.

Findings

Malignant transformation is more common in long-standing, advanced hidradenitis suppurativa.

Delayed diagnosis is associated with high mortality in these cases.

Radiotherapy was recommended as primary treatment due to the local extent of the cancer.

Abstract

Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by recurrent nodules, abscesses, and sinus tracts, most often located in axillary, inguinal, and gluteal regions. Malignant transformation into squamous cell carcinoma is a rare but serious complication. We present the case of a 50-year-old man with ˃10 years of poorly controlled hidradenitis suppurativa who developed painful gluteal discharge and multiple exophytic lesions. Imaging demonstrated large perianal and perineal masses with destruction of the coccyx, but no distant spread. Biopsy confirmed well-differentiated squamous cell carcinoma. Because of the local extent, the multidisciplinary team recommended radiotherapy as the primary treatment. Malignant degeneration of hidradenitis suppurativa is more frequent in long-standing, advanced disease, particularly in gluteal and perineal areas, and is associated with delayed diagnosis and high mortality. Early biopsy of suspicious lesions and multidisciplinary management are essential to improve prognosis.

Figures