Urethral fistula and sinus formation in hidradenitis suppurativa

Two patients with severe hidradenitis suppurativa are reported. In Case 2, with widespread and superficial disease without communication with internal organs, there was a good response to intensive surgical intervention. In the patient with hidradenitis suppurativa and urethral fistula formation adequate surgical treatment was not technically feasible and treatment had to be continued for at least 2 years without permanent cure in sight. A search of the literature confirms that this differentiation is important as the cases with fistulous involvement of internal organs tend to have a bad prognosis.