1. Image Challenge Q:
A 27-year-old man presented with a 2-year history of acne and the recurrence of multiple painful lesions in the genital and perineal areas. Examination revealed inflamed and noninflamed nodules and scar tissue in the genitofemoral area, axilla, intergluteal area, and behind the ears. What is the diagnosis?
1. Blastomycosis
2. Cat scratch disease
3. Hidradenitis suppurativa
4. Lymphogranuloma venereum
5. Epidermal inclusion cyst

2. Image Challenge Q:
A 27-year-old man presented with a 2-year history of acne and the recurrence of multiple painful lesions in the genital and perineal areas. Examination revealed inflamed and noninflamed nodules and scar tissue in the genitofemoral area, axilla, intergluteal area, and behind the ears. What is the diagnosis?
Answer:
Hidradenitis suppurativa
The diagnosis is hidradenitis suppurativa. Hidradenitis suppurativa is a chronic, inflammatory, recurrent skin disease of the hair follicles. The cause of hidradenitis suppurativa is unknown. Treatment includes a combination of surgery and topical and systemic antibiotics; in severe cases, systemic immunosuppressive agents may be considered.