Back and face involvement in hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (HS) may be associated with face and back lesions which are considered as acne.

OBJECTIVE: To describe the skin lesions of a group of patients with HS.

METHODS: Twelve patients were selected from a series of 648 patients on the basis of their specific skin lesions.

RESULTS: The patients (mostly male) had typical hidradenitis. On their face or back they had one or several of the following skin lesions which are not seen in acne: hypertrophic rope-like bridged scars, raised plaques with multiple carbuncle-like openings or with ulcerations, 'worm-eaten scars' and coalescent nodules with round ulcerations. All patients had deep round scars. Several had a pilonidal cyst or large epidermal cysts. Isotretinoin had been used by 7 patients with no effect.

CONCLUSION: Some HS patients have specific lesions of the face and back which are not acne and have to be treated differently.