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case_images: (A) Scattered folliculitis, small cysts on the head.(B) Sieve-like sinus tract in the neck.
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case_images: (A) Facial acne vulgaris lesions.(B) Scattered atrophic scarring on the back.
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case_images: It starts slowly with pimples, papules, pustules and cysts; the lesions gradually merge and become cysts, which are soft and fluctuating to the touch, and when they burst, they may discharge foul-smelling pus or mucous slurry, forming sinus tracts, which communicate with each other underneath the skin, and forming atrophic or hyperplastic scars on the skin (Figure 2).
case_images: (A-C) (Dorsal skin mass) The skin tissue was sent for epidermal hyperkeratosis and hyperkeratosis, hypertrophy of the stratum spinosum, spongy oedema, infiltration of inflammatory cells such as lymphocytes, plasma vesicles, and neutrophils in the dermis and around the appendages, and abscess formation was seen.
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case_images: A biopsy of the dorsal skin tissue was performed after admission to the hospital (Figure 3).  
case_images: (A and B) Localised erythema and swelling with paradoxical severe pain in the left leg.
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case_images: It occurs most often in areas where sweat glands are distributed, such as the axilla, anus and around the external genitalia, and may involve the buttocks (Figure 4A and B).The causes of HS are complex and are thought to be related to factors such as obesity, abnormal blood sugar levels, genetics, and other drug triggers. Follicular occlusion followed by follicular rupture has been shown to be crucial to HS development, leading to immune response activation, and resulting in typical clinical HS lesions.Chronic suppurative sweating adenitis is characterised by deep abscesses draining pus outwards through sinus tracts, skin breakdown and formation of irregular scarring, especially around the pustule, anus and external genitalia with many abscesses, sinus tracts, pus and blood discharge, and a high degree of swelling of the soft tissues; the sinus tracts may merge into a sheet, with extensive subcutaneous necrosis and ulceration of the skin, which can be extended to the perianal area, scrotum, labia, sacrococcygeal area, buttocks, lumbar area and femoral area, and often leads to Sclerosis and scar formation (Figure 4C). 
case_images: (A) Chronic suppurative sweating in the axilla and formation of hyperplastic scarring. (B) Chronic suppurative sweating on the inner thighs. (C) Multiple sinus tracts and scar formation on the buttocks.
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case_images: Before the patient was admitted to the hospital, there was a skin lesion on the left lower leg, which was not consistent with the skin lesion manifestation of intense pain and rapid progression of the disease made us highly suspicious of necrotising fasciitis (Figure 5), although the patient came to the hospital for the treatment of follicular atresia trichotillomania, but the skin lesion of the left lower limb was suspected to be necrotising fasciitis, and the disease progressed quickly, the condition was urgent and serious, and even serious or even life-threatening, so priority was given to the treatment of necrotising fasciitis, and the treatment of necrotising fasciitis was postponed for a while.
case_images: (A-C) (Skin tissue of the left lower leg) Sent skin tissue with epidermal hyperkeratosis and hyperkeratosis, hypertrophy of the stratum spinosum, spongiotic oedema, inflammatory cellular infiltration of lymphocytes, plasma cells, neutrophils and other inflammatory cells in the dermis and around the appendages.
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case_images: MRI of the affected limb, the left calf biopsy suggests (Figure 6).Immunofluorescence results: C3(-), IgA(-), IgG(-), IgM(-). MR (3.0T) scanning of the soft tissue of the left lower leg suggests: 1 Multiple abnormal signal shadows in the bone marrow cavity of the left upper and lower tibia and the inner and outer condyles of the femur, consider femoral infarction; 2.
case_images: (A) VSD negative pressure suction therapy. (B) Removal of VSD negative pressure suction device.(C)post-traumatic surgery.(D)Recovery period after epidermal grafting.
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case_images: After several debridement procedures and VSD negative pressure suction, the infection was controlled and finally epidermal graft repair was performed (Figure 7).   
case_images: (A-C) (Skin of the left lower leg) Focal epidermoid cyst rupture with infection and multinucleated giant cell reaction was seen in the skin sent for examination, focal squamous epithelial infiltrative growth, scattered cellular nests were seen in the interstitium, and mild cellular heterogeneity was seen.
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case_images: Due to its increasing incidence and high recurrence rate, it has attracted more and more attention from the public.On November 27, 2023, intraoperative histopathology of necrotizing fasciitis in the left calf (Figure 8) suggested that highly differentiated squamous cell carcinoma is considered.There is no family history of squamous cell carcinoma in this patient.The exact cause of the patient's pathogenesis has not yet been clarified, and it is considered that it may be related to a state of immunosuppression due to prolonged chronic inflammatory stimulation of the FOT and prolonged oral hormone therapy. 
case_images: (A-C) (Medial left calf lesions (top) and (bottom), lateral left calf lesions (top) and (bottom), and central left calf lesion) The skin tissue sent for examination showed fibrotic tissue hyperplasia with inflammatory cell infiltration of lymphocytes, plasma cells, neutrophils, etc., and a multinucleated giant cell reaction was seen.
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