Presentation
Suppurative lesion in the left axillary region associated with cutaneous phlegmetic changes.
Patient Data
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:
stage 1. Solitary or multiple isolated abscess formation
stage 2. Recurrent abscesses, single or multiple widely separated lesions. Sinus tract formation
stage 3. Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses. Fistulation and scarring. Often managed surgically