Hidradenitis Suppurativa (HS) is a chronic inflammatory disease of the skin starting from the apocrine glands and mainly involving the axilla, perineum and perianal area. It is clinically defined by the onset of painful subcutaneous nodularities, associated with signs of local inflammation, whose progression proceeds towards the definition of true subcutaneous abscess collections from which fistulous pathways branch off. These lesions result in severe fibro-cicatricial deformities. The diagnosis of HS, which is basically clinical, is followed, due to the recurrent/relapsed nature of the disease, by a difficult therapeutic management, which makes use of different treatments depending on the severity of the pathological picture, ranging from topical or systemic medical therapy to surgical excision. Imaging examinations, although not specific enough in the diagnosis of HS, are essential to define the loco-regional extension of the disease and to exclude possible alternative diagnoses. In particular, MRI plays a key role in the study of HS with anogenital localization, both for the recognition of lesions in the active phase and for the assessment of the local extension of the disease
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