Verrucous carcinoma arising in hidradenitis suppurativa

There are many reported cases of squamous carcinoma complicating hidmdeniti s suppurativa, but only one previous mention of verrucous carcinoma in this setting, We describe a case of verrucous carcinoma arising in hidradenitis suppurativa of the anal margin in a nonimmunosuppressed man. This is the s econd report of verrucous carcinoma arising in a lesion of hidradenitis sup purativa. Although hidradenitis suppurativa can involve multiple intertrigi nous sites, malignant degeneration occurs mostly in the anogenital region. This suggests a role for a regional factor which, when combined with chroni c inflammation, predisposes to malignant degeneration. A likely candidate f or this factor is human papillomavirus; our case showed histologic evidence for this, but the specimen did not show viral DNA by polymer ase chain rea ction in situ hybridization. The ability of anogenital hidradenitis suppura tiva to form squamous and verrucous cancels reinforces the argument for ear ly and complete resection.