Advanced hidradenitis suppurativa presenting with bilateral vulvar masses

Hidradenitis suppurativa is a chronic suppurative inflammatory disease of the apocrine sweat glands. It is more common in women and involves the genital region in half of all affected patients. An advanced case of hidradenitis suppurativa with bilateral vulvar masses is presented. Possible etiologies of the disease are discussed, as well as strategies for definitive therapy. Because the disease frequently affects the female external genitalia and therapy can require extensive surgical resection and reconstruction, the services of a gynecologic oncologist may be required. Adequate therapy based on an understanding of the pathophysiology of the disease can yield significant relief of symptoms.