A case of squamous cell carcinoma complicating hidradenitis suppurativa

A case of extensive squamous cell carcinoma arising in widespread perianal and inguinal hidradenitis suppurativa is used to illustrate the pathological features which influence management. The surgical pathology, with wide extension along subcutaneous sinuses, frequently leads to the view that it is incurable. A planned surgical approach, using both immediate frozen section and delayed paraffin histology to assess clearance margins allowed complete surgical excision in two stages. Colostomy is not a necessary part of management and healing by granulation is an acceptable alternative to extensive reconstruction procedures. Radiotherapy and chemotherapy, sometimes used in palliation mode, are not likely to be beneficial.