Which condition presents with recurrent painful nodules and abscesses in the axillae, commonly associated with smoking and obesity?

• A. Acne vulgaris
• B. Eczema
• C. Psoriasis
• D. Hidradenitis suppurativa

Answer: (D)

Hidradenitis suppurativa is a chronic inflammatory skin condition that targets apocrine-gland–bearing areas, especially the axillae, groin, and other intertriginous sites. It presents with recurrent painful nodules that can progress to abscesses, sinus tract formation, and scarring. The pattern described—recurrent painful nodules and abscesses in the axillae with association to smoking and obesity—is classic for this disease, since these factors commonly accompany HS and can worsen its activity.

Acne vulgaris mainly features comedones and inflammatory papules or nodules on the face, chest, and back rather than primarily in the axillae. Eczema tends to present as itchy, eczematous patches, often with visible dryness or oozing, not recurrent axillary abscesses. Psoriasis shows well-demarcated plaques with silvery scales, typically on elbows, knees, scalp, or extensor surfaces, and does not classically present as recurrent axillary abscesses.