Hidradenitis suppurativa (HS) is a chronic inflammatory, non-contagious and frequently debilitating skin disease. The occurrence of recurrent painful nodules, draining sinus tracts, and abscesses explain this condition. 

Axillary, perineal, inguinal, intermammary, and inframammary regions are most frequently affected. It has a global prevalence rate of up to 4%. 

Although its etiology is still unknown, the understanding of its pathogenic process has largely grown. Earlier it was considered to be an infectious process of the apocrine gland but is now known as a disease of follicular occlusion. 

A study discussed the hidradenitis suppurativa of an uncommon site along with its clinical presentation, diagnostic challenges, and management. 

A report describes a case of a patient who underwent a surgical incision and drainage of the deep neck abscesses and was monitored continuously by ENT and compared to other cases. As HS is mostly present in the axillary, perineal, inguinal, and gluteal regions, this rare case reports HS in the neck region. 

Following surgical intervention, the patient was given prolonged antibiotic therapy for the resolution of symptoms. The diagnosis of HS is mainly clinical which is based on typical lesions, location, and chronicity; which can be complicated by phenotypic variations.

Furthermore, a delay in diagnosis is common due to the resemblance of the early lesions of HS to other skin conditions. In deep-seated lesions, CT scans and ultrasounds can serve as an important diagnostic tool.

HS can be associated with multiple comorbidities and if persistent can lead to complications. Its treatment is challenging due to its recurrence and lack of curative therapies.

Source: Harvey LM, Fortson JK. Hidradenitis Suppurativa at an Uncommon Site: A Review of Its Clinical Features, Diagnostic Difficulties, and Management. Cureus. 2021 Oct 12;13(10):e18704. doi: 10.7759/cureus.18704. PMID: 34790460; PMCID: PMC8584235.