Atypical facial hidradenitis suppurativa complicated by periorbital cellulitis: Case report and literature review

Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by recurrent abscesses, nodules, and sinus tracts, most commonly affecting hair-bearing, intertriginous areas such as axillae, groin, and inframammary regions. Cervicofacial presentation is rare, with limited literature including only one case describing periorbital involvement. Due to its atypical location and clinical resemblance to common soft-tissue infections, facial hidradenitis suppurativa can be challenging to manage. We present a unique case of a patient with known hidradenitis suppurativa and uncontrolled diabetes (HbA1c 12.1) who developed a left perioral and periorbital abscesses and, despite prompt treatment, experienced worsening facial swelling requiring surgical drainage.