A 19-year-old woman complains of severe pain in the axillary crease. Condition onset occurred a week ago after her swimming in a cold river and epilation. The next day a painful "boil" appeared. The "boil" was increasing in size every day and became a plum-sized tumor. Upon examination there are nodular conical growths joined together detected, the skin covering them is bluish-red in color. Some nodules have fistulous openings producing thick purulent mass. Body temperature is 38,5°C, general malaise. What is the most likely diagnosis?

Answer options

1. Hydradenitis
2. Pyoderma chancriformis
3. Carbuncle
4. Necrotizing ulcerative trichophytosis
5. Cutaneous tuberculosis

Explanation

Hidradenitis is a follicular occlusion followed by folliculitis and secondary infection with skin flora (usually Staphylococcus aureus and Propionibacterium acnes) culminates in chronic suppurative, painful, skin abscesses, sinus tracts, and scarring. HS occurs in skin containing apocrine glands, commonly in the axillae and groins, but also the scalp, breast, chest, and perineum. It has a genetic predisposition with variable penetrance and is strongly associated with obesity and smoking. It affects four women for every man. Bailey & Love’s short practice of surgery. – 27th edition. – P. 595.