The Two Less Frequently Involved Zones

The breast may be involved in women, particularly the sub-mammary folds, sometimes the inter-mammary fold (see Fig. 3.16) and the are-

Fig. 3.16. Inter-mammary HS

Fig. 3.17. Perianal and buttock involvement

ola. These lesions have the same characteristics as HS lesions elsewhere and are, as a rule, easily differentiated from acne lesions. It is a clinical diagnostic aid that comedones are not present in HS.

In contrast, the perineal and perianal zones are mainly involved in male patients (see Fig. 3.17). When this zone is the only one involved, HS has to be differentiated from several conditions especially pilonidal sinus and Crohn's disease, see Chaps. 6, 7.

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