Background: Verneuil’s disease is a rare suppurative pathology of apocrine glands and pilosebaceous
system of the inguinal-pelvis and perianal region with a multifactorial aetiology. The disease produces skin
fistulas, draining a serum-purulent material on the skin, and finally with spontaneous healing. Verneuil’s
disease can be complicated by recurrence, and unfortunately, by squamous carcinoma. We have found in
literature, just 2 cases of Hidradenitis Suppurativa, complicated by Verrucous Carcinoma.
Main Observation: we describe a patient F, 34-year-old, comes to our observation at 4th gestational month,
with suppurative sinus pilonidalis diagnosis and with the absolute indication of the gynaecologist to the
abortion. We decided to continue the pregnancy. The patient gives birth with C. to 9 months; the new-born
baby was perfectly healthy and after the maternal milk analysis, the baby also nursed for about 2 months.
Finally, we decided to perform a wide excision biopsy and after a controversial histology (first Warty
Carcinoma, then after a “second view” Suppurative Hidradenitis), we started a series of medical treatments,
including biological therapy with Infliximab, but unfortunately with fleeting results. The patient did not
answer substantially. Therefore, the last chance appears a combined demolitive and plastic surgical
treatment. The histology described a Verrucous squamous cell carcinoma maximum diameter of 38 x 26
cm, with lateral deep margins free of neoplastic involvement.
Conclusion: This very advanced clinical behaviour of the Hidradenitis Suppurativa can present in
pregnancy, therefore, motivating the interruption of the same one. Our experience contributes to underlining
the possibility to bring to term the pregnancy. This case report shows how the hormonal activity can anyway
influence the development of the hidradenitis and an interesting hypothesis could consider the hormonal
activity of the pregnancy and the HPV promoting gene regulation (RB) from inflammatory pathology to
neoplastic pathology in VC like a model to study.
Targeting human milk fortification to improve very preterm infant growth and brain development: study protocol for Nourish, a single-center randomized, controlled clinical trial
