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109 Intergluteal Contour Deformity in Hidradenitis Suppurativa Maria Letizia MUSUMECI 1 , Giulia CAPUZZO 1 , Barbara CAMMISULI 2 , Antonio PESCE 3 , Alessandra SCILLETTA 1 and Giuseppe MICALI 1 * Dermatology Clinic, University of Catania, AOU Policlinico-Vittorio Emanuele, PO “Gaspare Rodolico”, Via S. Sofia 78, IT-95123 Catania, Faculty of Medicine, University of Palermo, Palermo, and 3 Department of Medical and Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, University of Catania, Catania, Italy. *E-mail [email protected] 1 2 Accepted Sep 4, 2018; Epub ahead of print Sep 5, 2018 Hidradenitis suppurativa (HS) is an uncommon chronic disorder with a significantly negative impact on the qua- lity of life of affected patients. HS is typically localized on the axillary and inguinal folds, less commonly on the breast and at perianal/perineal areas, whereas gluteal in- volvement is generally considered atypical (1). Extensive HS involvement may interfere with everyday activities, such as walking or hugging, due to pain in the groin or axillary area, or sitting in case of gluteal localization. Current clinical classifications of HS are not specific and present serious limitations (2). Recently, a new clas- sification, considering 5 phenotypes that include regular, frictional furuncle, scarring folliculitis, conglobata, syndromic and ectopic types, has been proposed (2). Frictional furuncle and scarring folliculitis types share gluteal involvement. Based on the observation of intergluteal contour deformity in some of our patients with HS and in cases from the literature (1, 3, 4), we considered whether this finding may represent a common sign of HS and if it may have a correlation with specific HS localization and disease severity. CASE REPORTS A total of 74 patients with HS (37 males (M)/37 females (F)) were evaluated from November 2016 to February 2018. Twenty-five (34.2%; 13 M/12 F) showed invol- vement of the gluteal and/or perianal/perineal areas, respectively, in 14 (7 M/7 F) and 17 (8 M/9 F) patients (6 patients showed both localizations). Of these, 8 (10.8%; 3 M/5 F) showed a deformity of the intergluteal contour. This consisted of an irregularly bending serpiginous outline of the intergluteal fold showing contractures and skin induration corresponding to multiple and opposed retractive scars. In some cases the skin surrounding the contour deformity appeared hyperchromic (Fig. 1). All 8 patients clinically fitted into frictional furuncle type from van der Zee & Jemec (2) recent classification and their HS severity was rated Hurley II–III; disease mean duration was 12.5 years (range 3–25 years). None of them showed a positive family history for HS, but 6 (75%) had a past history of acne. Obesity was present in 2 cases (25%). All patients reported a sedentary lifestyle similar to those without gluteal involvement matched for age, sex, disease severity and body weight. SHORT COMMUNICATION Fig. 1. Multiple intergluteal contour deformity (arrows) resulting from dermal contractures and induration in patients with Hurley II–III long- lasting disease. This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3033 Acta Derm Venereol 2019; 99: 109–110