S Levonorgestrel Hidradenitis suppurativa: case reportA 34-year-old woman developed hidradenitis suppurativa while receiving levonorgestrel via an intrauterine device.The woman had a levonorgestrel 20 µg/day intrauterine device fitted due to heavy menstrual bleeding with anaemia. Four months after placement of the device, hidradenitis occurred in the bilateral groin and axillary region.The woman attended a dermatology service, and was commenced on a sulfone, clindamycin and isotretinoin. The lesions persisted, and required surgical drainage on three occasions with resection of fistulous tracts. Due to suspicions about the possible androgenic effects of levonorgestrel, the intrauterine device was removed. A clear clinical improvement was observed, with no new outbreaks of hidradenitis suppurativa 3 years after removal.Author comment: In our case, the time relationship between the insertion of the levonorgestrel-intrauterine device, the appearance of the lesions, and the clinical improvement after its withdrawal led us to believe that the hyperandrogenism induced by progestin was a significant etiological factor.