Vulvar hidradenitis suppurativa associated with leprosy: a diagnostic challenge in an atypical presentation
DOI:
https://doi.org/10.5327/2237-4574-241Keywords:
hidradenitis supurativa, leprosy, vulvaAbstract
Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis that affects intertriginous areas, including the vulvar region, and may represent a diagnostic challenge in atypical or refractory cases. Leprosy, an infectious disease still endemic in countries such as Brazil, can mimic several inflammatory dermatoses, making differential diagnosis difficult. A case of a 53-year-old female patient with long-standing vulvar HS, previously treated with multiple surgical and clinical approaches, with a partial response, is reported. During evaluation for immunobiological therapy, atypical cutaneous lesions were identified, prompting histopathological investigation, which confirmed the diagnosis of leprosy. This case highlights the importance of an expanded diagnostic approach in patients with atypical clinical progression of HS, particularly in endemic regions. It also emphasizes the need for careful differential diagnosis prior to the initiation of immunosuppressive therapies, given the risk of reactivation of chronic infections. Specialists in lower genital tract pathology play a key role in early recognition and appropriate management of such cases.
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