Poland Syndrome with Ipsilateral Hypoplasia of Gluteal Muscles and Contralateral Hidradenitis Suppurativa

Abstract

SummaryBackgroundPoland syndrome (PS) is a rare congenital anomaly associated with absent or hypoplastic pectoralis major muscle and a wide spectrum of ipsilateral thoracic and upper extremity deformities. Hidradenitis suppurativa (HS) is a recurrent inflammatory follicular disease that commonly affects the apocrine-bearing skin and involves follicular occlusion and hyperkeratosis.Case ReportWe report a case of a 46-year-old male with a history of chronic recurrent hidradenitis suppurativa who was incidentally found to have a simple type of Poland syndrome with incidental hypoplasia of ipsilateral gluteal muscles.ConclusionsNot only can PS present with HS, which we describe for the first time, but it is also associated with a wide variability of symptoms such as previously unknown co-existence of gluteal muscles hypoplasia.

Should We Scan Hidradenitis Suppurativa Patients? A Systematic Review of Radiologic Findings

“…The PET-CT examinations performed in all the noted cases were not aimed to detect HS. These subcutaneous lesions did not have a metastatic pattern and were considered consistent with HS 12,17,58 . Accordingly, atypical distribution of hypermetabolic foci must be considered with the patient’s medical history to avoid misdiagnosis 58 .…”

“…Relevant adverse effects of the tracer, such as allergic manifestations, are infrequent 56 . This search retrieved three case reports about [ 18 F]-2-fluoro-2-deoxy- d -glucose in patients with cancer who happened to have HS as an incidental finding 12,17,57,58 . The PET-CT examinations performed in all the noted cases were not aimed to detect HS.…”

“…Manifestations of HS in CT are persistent, thick-walled, low-attenuation collections in subcutaneous tissues with abnormally enhanced softtissue infiltration in adjacent fat, thickening of the overlying skin, and reactive hyperemia on lymph nodes. 12 Although affected tissue is solid, hyperdense tissue, the fistulous tracts may not be entirely distinguishable because of limited resolution; muscle, healthy, and inflamed soft tissue identifications are jeopardized when using CT. Consequently, one study 16 used additional MRI before surgery. When comparing imaging methods, MRI revealed the lesions' exact location, and other major fistulas were identified.…”

“…Differential diagnoses include carbuncle, epidermoid or dermoid cysts, erysipelas, boils, venereal lymphogranuloma, granuloma inguinal, skin tuberculosis, and other diseases from the follicular occlusion tetrad (acne conglobata, scalp dissecting cellulitis, and pilonidal sinus) 1,3 . Cutaneous Crohn disease (CD) must be considered and differentiated from HS in the perianal location 12 . Sometimes, deep-seated HS manifestations or early inflammatory changes are difficult to detect, going unnoticed during regular physical examinations 13,14 …”

“…1,3 Cutaneous Crohn disease (CD) must be considered and differentiated from HS in the perianal location. 12 Sometimes, deep-seated HS manifestations or early inflammatory changes are difficult to detect, going unnoticed during regular physical examinations. 13,14 Although HS diagnosis is mainly based on clinical aspects, histopathology is still the criterion standard for diagnostic accuracy.…”