Hidradenitis Suppurativa: A Case of Scarring-Induced Immobility

Introduction Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting the hair follicles, with a prevalence of 0.7- 1.2% in the populations of Europe and the United States [1]. This condition often requires outpatient care; however, disease progression may necessitate hospitalisation for surgical intervention [2]. HS is characterized by one of the lowest patient-reported quality of life scores among dermatological disorders and is associated with significant comorbidities, elevated hospitalization rates, and treatment resistance [3]. Case Presentation A 41-year-old patient presented with multiple axillary scars, facial abscesses, and impaired arm elevation, with symptoms persisting for 1.5 years despite ineffective conservative and surgical treatments. Examination revealed hypertrophic scars, comedones, abscesses, and inflammatory nodules with purulent secretions in both axillae. Biopsies showed dermal sclerosis, squamous epithelium-lined cavities, and significant connective tissue proliferation, which contributed to reduced limb mobility, confirming chronic suppurative hidradenitis. The patient underwent excision of the affected axillary areas, followed by fasciocutaneous plasty and autologous skin grafting from the thighs. The postoperative course was uneventful, and the patient was discharged on day 17 with wound care instructions and follow-up for graft healing. Discussion Mucinous hidradenitis is a rare condition with atypical skin lesions, often requiring surgical intervention. Diagnosis is challenging due to potential autoimmune mechanisms, and conservative treatments are typically ineffective [4]. Given the diverse risk factors, prolonged healing, and the limited understanding of its pathophysiology, international guidelines and multidisciplinary approaches are necessary to improve management and outcomes, particularly for patients with limb immobility. Conclusions This uncommon case highlights the clinical impact of recurrent hidradenitis suppurativa and its scarring, which led to limb immobility in the patient. Effective management requires a multidisciplinary approach, with surgical interventions tailored to disease severity and patient preferences [5]. Regular follow-ups of such exceptional cases are crucial for early intervention and preventing progression.