Hidradenitis suppurativa complicated by erosive arthropathy and ulcerative keratitis

Hidradenitis suppurativa is a chronic suppurative and cicatricial disease of the apocrine glands of the skin. We present a 44-year-old African-American male patient with a history of hidradenitis suppurativa who developed recurrent bilateral peripheral ulcerative keratitis and erosive arthritis of the wrists. These are rare complications of hidradenitis suppurativa. The peripheral ulcerative keratitis responded well to prednisone; immunosuppression with cyclophosphamide was added to attempt to prevent further recurrences. Peripheral ulcerative keratitis probably has an immune mechanism similar to that of the arthritis that may complicate hidradenitis suppurativa and may require aggressive immunosuppressive therapy.