Overall, the values reflected a population adherent to both topical and oral medications, with no significant difference in adherence between the two. However, the methodologies used by many of the studies were weak, and the findings are not consistent with results of more objective measures of adherence. The leading factors that contribute to poor adherence may be reduced with enhanced patient consultation, reminder systems, and education.

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Scrotal elephantiasis occasionally presents in conjunction with hidradenitis suppurativa (HS). A 39-year-old morbidly obese African American man, with a previous smoking history, has a 20-year history of HS complicated by a 3-year history of scrotal elephantiasis. His Hurley Stage III HS affects the scrotum, penis, lower abdomen, bilateral groin, and buttock regions. Although his scrotal edema is likely attributed to his history of HS, other causes were ruled out. A computed tomography scan of pelvis with intravenous contrast revealed edematous enlargement of the scrotum and multiple inflammatory abscesses consistent with HS. His condition was complicated by development of infection of the scrotal, perineal, and penile areas. He is currently on adalimumab 40 mg weekly and uses silvadene 1% cream topically. Improvement of his HS has been attributed to the current medical regimen and weight loss. He is responding well to implemented adalimumab for HS with no adverse effects reported. He has undergone several irrigation and debridement procedures for scrotal elephantiasis with success. He is currently preparing for gastric bypass surgery and lumpectomy after this procedure.

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