New Onset Lesion in Patient with Hidradenitis Suppurativa.

A 59-year-old man was referred to the coloproctology unit with a 3-year evolution of a chronic perianal hidradenitis suppurativa that was refractory to apatinib. The purpose of the referral was to evaluate a surgical approach. Once the patient was assessed, a local exeresis of the lesion with wide margins was performed in the operating room under epidural anesthesia. During the surgical procedure multiple fistulous tracts with active suppuration were revealed (Fig 1). After a month of favorable wound evolution, a lesion with these characteristics (Fig 2) grew on granulation tissue. What is the diagnosis? A.Aberrant granulation tissue B.Malignant keratoacanthoma C.Epidermoid carcinoma (Correct answer) D.Apatinib-induced HPV infection Fig 2Verrucous lesion on the surgical site one month after surgery. View Large Image Figure Viewer Download Hi-res image