We describe 4 patients who were seen between 2010 and 2011 with a unique presentation of hidradenitis suppurativa (HS) involving the posterior neck or occiput. Diagnosis was based on the morphologic characteristics of inflammatory nodules and sinus tracts as well as a history of failed treatment with antibiotics and isotretinoin in all patients. Dissecting cellulitis was ruled out owing to either lack of scalp involvement or only segmental scalp involvement.
A 27-year-old healthy white man presented with a 17-year history of HS distributed mainly on the nape of his neck but also involving his axillae bilaterally. Inflamed nodules and atrophic scarring along the posterior aspect of his neck were noted on physical examination (Figure 1).
Syed ZU, Hamzavi IH. Atypical Hidradenitis Suppurativa Involving the Posterior Neck and Occiput. Arch Dermatol. 2011;147(11):1343–1344. doi:10.1001/archdermatol.2011.329
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