A 22-year-old woman was referred with the diagnosis hidradenitis suppurativa. The primary complaint was recurring painful and inflamed lesions of the axillae. Minor asymptomatic lesions had persisted from early childhood, but for a couple of years the condition had worsened with more frequent inflammation and pain. The patient's father and sister had experienced the same symptoms. In her siblings treatment with isotretinoin has been attempted with varying effect. Microbiological investigation

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... lesions initially showed no growth of bacteria or fungi. On examination, the patient presented with tender nodules and suppurating abscesses in the groin, the axillae ( Fig. 1) , proximal extremities, the neck, on the abdomen and the scalp. When punctured elements oozed creamy/oily fluid. A skin biopsy revealed cystic structures with squamous epithelium without granular layer. Sebaceous glands near the cyst wall. Cysts contained fragments of hair. There were no signs of malignancy.