patient presented with swellings involving the groin , axillae , chest , and intergluteal area . he was treated with antibiotics and incision and drainage of abscesses . following many investigations including mri , immunological , and microbial studies , a severe case of hidradenitis suppurativa he is currently under consideration for plastic reconstruction ( figs .  1 , 2 , 3 ) . hidradenitis suppurativa is a chronic disfiguring skin disease affecting areas bearing apocrine sweat glands , characterized by chronic abscesses ; epidermoid , sebaceous , or pilonidal cysts ; or multiloculated infections . it usually goes undiagnosed due to a delay in seeking treatment and is frequently misdiagnosed . traditionally , it has been attributed to the occlusion of the apocrine duct by a keratinous plug . as a result , the cysts can be extremely tender and persist for years with intermittent periods of inflammation , which may need incision and drainage of pus . this process often leads to open wounds with healing problems , sinus tract formation , and chronic scarring .
key clinical messagehidradenitis suppurativa ( hs ) is a chronic disfiguring skin disease affecting apocrine sweat glands , characterized by abscesses , cysts , or infections . 
 there is currently no cure or a consistently effective treatment . 
 hs is a challenging condition to diagnose and treat . 
 we present a severe case to raise awareness of this disabling condition .