Three fatal cases of squamous cell carcinoma arising in chronic perineal hidradenitis suppurativa

INTRODUCTION Hidradentis suppurative (HS) is a chronic, inflammatory and suppurative disorder of skin bearing apocrine glands. The most severe complication is squamous cell carconoma (SSC) and we here present three cases, all of which proved fatal, and review the past 40 years of published cases. PATIENTS AND METHODS Three advanced cases of SSC arising in chronic HS have been referred for reconstructive surgery over the past 40 years were identified using a Medicine search (search items in combination: hidradentis, squamous, carcinoma). RESULTS The male female ratio was 4.1, most (61%) were perinea or buttock. We found no reports of SCC arising in axillary disease. The symptomatic history of HS prior to SCC diagnosed ranged from 3-50 years with a mean 25 years. Age at diagnosis of SCC ranged from 27-71 years, and 15 patients (48%) died within 2 years. Age at diagnosis SCC ranged from 27-71 years, and 15 patients (48%) died within 2 years of SCC diagnosis. CONCLUSIONS We advocate that hidradentitis suppurative arising in extra-axillary sites is a pre-malignant conditin, and should not be treated conversely, curative resection is the mainstay management.