Rarely seen accelerated progression of hidradenitis suppurativa

Malignant nodular hidradenoma, also known as Malignant Hidradenocarcinoma (MHA), is a rare tumor of sweat glands that accounts for less than 0.001% of all tumors [1-3,14]. Although it typically arises de-novo, MHA rarely progresses from hidradenitis suppurativa (HS), a disorder of apocrine glands characterized by chronic inflammation [5,6,9]. HS is due to recurrent follicular occlusion leading to painful debilitating cutaneous/subcutaneous abscesses requiring drainage [5,6,9]. Common sites include axillary, anogenital and inguinal regions [5,6,9]. The worldwide prevalence of HS is 1%-4% [5,6]. Incidence of all eccrine carcinomas is ~ 6% [14]. Risk-factors include family history, obesity, and smoking [5,6,9]. Severe complications associated with HS are squamous cell carcinoma and adenocarcinoma [2,6]. MHA progression is extremely aggressive with 60% cases having metastatic spread within the first 2 years of diagnosis [14].