Fig. 21

Surgically confirmed hidradenitis suppurativa in a 51-year-old man with hepatitis C, complaining of progressive, painful swelling of perineum, scrotum and penis, with thickened skin and fistulous orifices. Plain radiographs (a) excluded air collections in the swollen scrotum. MRI including multiplanar T2-(b–d), post- gadolinium axial fat-suppressed (e) and coronal (f) T1-weighted images depicted marked symmetrical thickening of the skin and subcutaneous planes with abnormal inflammatory signal intensity and hyperenhancement, (+ in e, f) involving the medial aspect of the thighs, perineal region and scrotum. Small purulent collections with peripheral enhancement (arrowheads) and inflamed inguinal lymph nodes were present. The testes (not shown) did not show appreciable abnormalities [Partially reprinted with permission from Ref. [71]]