Hidradenitis supparativa complicated by penoscrotal lymphedema and renal amyloidosis

Genital lymphedema usually develops after 4-30 years of chronic hidradenitis suppurativa (HS). However, our patient exhibited signs of it as early as 2 years after being diagnosed with HS. Renal amyloidosis is a rarely reported complication of HS. Unfortunately, our patient was asymptomatic but was found to have end-stage renal disease secondary to advanced renal amyloidosis. We report a case of a 42-year-old Indian gentleman who had HS for 9 years presenting with 2 rare complications: penoscrotal lymphedema and end-stage renal disease secondary to renal amyloidosis. The patient was treated with prednisolone and adalimumab to treat both his HS and renal amyloidosis, and was referred to general surgery to manage his genital lymphedema. We recommend following adult patients with moderate-to-severe HS and clinical duration of greater than 3 years and screening for amyloidosis before they reach end-stage organ disease, similar to what happened to our patient with end-stage renal disease.