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Orbit. 2014 Oct;33(5):382-4. doi: 10.3109/01676830.2014.894542.

Hidradenitis suppurativa of the periorbital skin with lacrimal sac and ethmoidal involvement.

Author information

1
Department of Ophthalmology, Conquest Hospital , Hastings TN37 7RD , United Kingdom and.

Abstract

PURPOSE:

To highlight a rare case of hidradenitis suppurativa affecting the periorbital skin in which chronic nodules resulted in a sinus tract connecting the lacrimal sac and ethmoidal sinus.

METHODS:

A single interventional case note review with clinical history, examination, results of investigations and details of medical and surgical management.

RESULTS:

The patient showed no response to antibiotics and steroids. One attempt at local drainage was unsuccessful. MRI showed a defined ring enhancing lesion anterior to the orbital septum overlying the medial canthus. Surgical exploration revealed a cutaneous fistula which tracked through the left orbicularis oculi into the medial canthal tendon and into the left lacrimal sac. A further fistula connected the lacrimal sac to adjacent structures and the lacrimal bone was found to be eroded.

CONCLUSIONS:

Hidradenitis suppurativa is a chronic skin disease which can involve the face. Inflammation, scarring and sinus tract formation are common findings. Periorbital lesions can spread to involve surrounding adnexal structures.

KEYWORDS:

Abscess; facial; hidradenitis suppurativa; periorbital; skin

PMID:
25191826
DOI:
10.3109/01676830.2014.894542
[Indexed for MEDLINE]

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