Probable association between hidradenitis suppurativa and Crohn's disease: significance of epithelioid granuloma.

Hidradenitis suppurativa affects apocrine gland-bearing areas of skin and may produce perianal lesions clinically indistinguishable from the cutaneous manifestations of Crohn’s disease1, suggesting an association between the two diseases1–3. A recent histological study3 of hidradenitis suppurativa described epithelioid granulomas in 10 per cent of cases. Some of these patients had systemic granulomatous disease, including Crohn’s disease3. A report is made of a case of granulomatous hidradenitis suppurativa complicated by the later development of gastrointestinal Crohn’s disease, and the concept of eventual development of systemic granulomatous disease is explored.