A 28-Year-Old Man With Draining Nodules and Cysts in His Axilla

A 28-year-old man with a medical history significant for mild hypertension and pre-obesity presents with bilateral draining nodules and cysts with sinus tract formation in the axillae (Figure). He has minimal involvement of the inguinal folds. A full-body examination of the skin reveals no other similar lesions, and there is notable sparing of the oral mucosa and nails. No lymphadenopathy was observed. The lesions have been present since his early teenage years and seem to wax and wane but never fully resolve. They can be very sore and periodically have a foul odor.