Infiltrative squamous cell carcinoma in hidradenitis suppurativa: A case report for early surgical intervention

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC). The pathogenesis of HS is poorly understood but thought to be from follicular keratinization, occlusion, and rupture of the pilosebaceous unit, followed by an infiltration of inflammatory cells into the dermis. Treatment is challenging due to a lack of effective medical therapies. PRESENTATION OF CASE: In this case report, we describe a patient with chronic HS that developed into SCC who underwent late surgical intervention after failing medical management. At the time malignant transformation was discovered, the SCC was beyond resectability and ultimately fatal. DISCUSSION: Based on the morbidity and mortality of chronic HS illustrated in our case and presented in the literature, we advocate for early surgical intervention. CONCLUSION: Wide surgical excision offers a near definitive intervention and should at least be considered for all chronic HS patients due to high morbidity and malignant transformation risk.