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INTRODUCTION

KEY POINTS

  • Hidradenitis suppurativa is a chronic inflammatory disease consisting of recurrent nodules, plaques, sinus tracts, fistulas, and scarring in intertriginous areas.

  • In lighter skin, this can be seen as pink to red in color in contrast to the violaceous or brawny appearance in skin of color.

  • In darker skin, later stages of the disease can present with hypertrophic or keloidal scarring.

image

FIGURE 23-1.

Purple-brown atrophic scars with surrounding linear cords and sinus tracts signifying scarring changes from chronic disease. (Reproduced with permission from Burgin S. Guidebook to Dermatologic Diagnosis. New York, NY: McGraw Hill; 2021, Figure 12-19.)

FIGURE 23-2.

Pink protuberant axillary nodules signifying active disease without sinus tracts or scarring that can be seen with more chronic disease. (Reproduced with permission from Prose NS, Kristal L. Weinberg’s Color Atlas of Pediatric Dermatology, 5th ed. New York, NY: McGraw Hill; 2017, Figure 2-34.)

FIGURE 23-3.

Pink to pink-brown nodules with background brawny erythema along the gluteal cleft. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 43-2B.)

FIGURE 23-4.

Pink to brown confluent patches, plaques, nodules, and linear cords with areas of overlying ulcerations and pustular drainage in the right axilla signifying active Hurley stage III disease. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 43-1B.)

FIGURE 23-5.

Pink atrophic plaques with surrounding linear cords and pink and brown patches signifying postinflammatory pigmentary changes from chronic disease in a young man. (Reproduced with permission from Wolff K, Johnson RA, Saavedra AP, et al. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 8th ed. New York, NY: McGraw Hill; 2017, Figure 1-18.)

FIGURE 23-6.

Violaceous patches and atrophic plaques in the axillary vault signifying chronic diseases with several active pink ulcerations at the inferior border of the axilla. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 84-4.)

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