Case Series of a Previously Undescribed Ulcerative Variant of Hidradenitis Suppurativa.

Introduction: Hidradenitis suppurativa (HS) is an auto-inflammatory disease characterized by recurrent painful nodules, abscesses, tunnels, and scarring, commonly seen in intertriginous body surfaces; however, an additional ulcerative phenotype has not been described and represents a specific clinical phenotype of the disease requiring special therapeutic considerations.

Case presentation: We report 4 patients with a previously undescribed, ulcerative phenotype of HS that did not respond to standard treatment but were healed with surgery. These lesions present as large, deep-dermal, erythematous, well-defined ulcers that are exquisitely tender.

Conclusion: This phenotype necessitates recognition by the clinician as a rapid path to combined pharmacologic and surgical management is crucial for the patient.