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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