Axillary hidradenitis suppurativa

Case contributed by Gerard Carbo
Diagnosis certain


Suppurative lesion in the left axillary region associated with cutaneous phlegmetic changes.

Patient Data

Age: 20 years
Gender: Male

Left axillary subcutaneous hypoechoic collection with mobile echogenic content and marked associated inflammatory changes (increased Doppler signal and hyperechogenicity of adjacent adipose tissue). There are also several enlarged axillary nodes, reactive in appearance.

Case Discussion

This condition (hidradenitis suppurativa) usually tends to present as axillary subcutaneous large pus collections. Diagnosis is clinical, and imaging is typically nonspecific. On ultrasound, hidradenitis suppurativa consists of a dermal / subdermal fluid collection, usually large in size, ranging from simple to complex.

Hurley stages of hidradenitis suppurativa:

  1. stage 1. Solitary or multiple isolated abscess formation

  2. stage 2. Recurrent abscesses, single or multiple widely separated lesions. Sinus tract formation

  3. stage 3. Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses. Fistulation and scarring. Often managed surgically

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