Peer Reviewed

Photo Quiz

A 28-Year-Old Man With Draining Nodules and Cysts in His Axilla

Isabelle Moseley, BA1 • Allison Robbins, MD2 • Oliver J. Wisco, DO3,4

    1Warren Alpert Medical School of Brown University, Providence, Rhode Island
    2Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
    3Director, Department of Cutaneous Oncology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
    4Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island

    Moseley I, Robbins A, Wisco OJ. A 28-year-old man with draining nodules and cysts in his axilla. Consultant. 2023;63(4):e3. doi:10.25270/con.2022.07.000018

    Received January 24, 2022. Accepted February 28, 2022. Published online July 29, 2022.

    The authors report no relevant financial relationships.

    The authors report that informed patient consent was obtained for publication of the images used herein.

    Isabelle Moseley, BA, Brown University, 339 Eddy Street, Providence, RI 02903 (


    A 28-year-old man with a medical history significant for mild hypertension and pre-obesity presents with bilateral draining nodules and cysts with sinus tract formation in the axillae (Figure). He has minimal involvement of the inguinal folds.

    Hidradenitis suppurativa

    Figure. Axillary nodules and draining cysts


    A full-body examination of the skin reveals no other similar lesions, and there is notable sparing of the oral mucosa and nails. No lymphadenopathy was observed. The lesions have been present since his early teenage years and seem to wax and wane but never fully resolve. They can be very sore and periodically have a foul odor.

    Based on the patient's history and physical examination findings, which of the following is the most likely diagnosis?

    A. Furunculosis
    B. Marjolin ulcer
    C. Hidradenitis suppurativa
    D. Intertrigo


    Answer and discussion on next page.


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