Here's another patient.The clinical picture is on the right and the MRIs are on the left. You can see from the MRIs just how extensive the involvement is. She had already had an operation and then it recurred. Unfortunately, she had refused further surgery and was simply applying dressings daily.
This is really a problem because the skin is abnormal, there are a lot of crevices and these cauliflower-type excrescences on her skin, there is cebum and bacteria and it always smells bad. She couldn't go to school because of the smell. One of the first things I was successful in doing with her was getting her to use Hibiclens and topicals to reduce the bacterial count so it didn't smell so bad and she could go to school.
I finally talked her into surgery and we had to remove all the skin from the iliac crest and inguinal ligament down to almost her knee and then graft it in order to remove this.