Marjolin's ulcer in chronic hidradenitis suppurativa.

Marjolin's Ulcer in Chronic Hidradenitis Suppurativa TO THE EDITOR: Hidradenitis suppurativa is a chronic inflammatory disease of the apocrine glands that most commonly involves the perianal, perineal, axillary, and inframammary regions. The etiology is poorly understood, with a genetic component, hormonal influence, and obesity being linked to the expression. Characteristic findings include dilated keratin-filled pores, scarring and sinus tract formation, malodorous discharge, and inflammation with secondary infection. Medical management consists of cleaning the areas, application of mild topical steroids with the concurrent use of systemic antibiotics, topical antibiotics, and intralesional steroids. Rarely, with chronic hidradenitis suppurativa, Marjolin's ulcer (a squamous cell carcinoma) develops. We report two cases of hidradenitis suppurativa in which squamous cell carcinoma developed after a latent period of 20 years and 35 years, respectively, despite repeated local excisions.