Recurrent Axillary Hidradenitis Suppurativa in a Patient with Uncontrolled Type 2 Diabetes Mellitus

Case Report

Abstract

Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin condition that predominantly affects areas rich in apocrine glands. This case report presents a 43-year-old male patient with a two-year history of recurrent axillary HS complicated by uncontrolled type 2 diabetes mellitus. The patient initially developed small nodular lesions measuring 0.53 cm in both axillae, which progressively worsened into extensive lesions with pain and purulent discharge. His medical history was significant for a 15-year history of diabetes mellitus managed with metformin and glimepiride, past smoking history of 25 years, and alcohol consumption. Laboratory findings revealed elevated inflammatory markers, uncontrolled blood glucose levels, and mild anemia. The patient underwent surgical excision of the lesions, followed by reconstruction using a thoracodorsal artery perforator (TDAP) fasciocutaneous flap for wound coverage. Postoperative management included a comprehensive approach with broad-spectrum antibiotics (amoxicillin-clavulanate, doxycycline, and metronidazole) and intensive insulin therapy. The patient showed significant improvement during the four-week hospital stay, with successful wound healing and better glycemic control. The case shows the potential impact of metabolic disorders on the progression and management of HS.