background. Hidradenitis suppurativa is a recurrent, chronic inflammatory disease with complications such as abscesses and sinus tract formations, fistulization, and scarring. Squamous cell carcinoma is rare, and is the most serious complication.objective. To present the evolution of squamous cell carcinoma in long-term hidradenitis suppurativa.methods. Case report and literature review.conclusion. Many conservative therapies have no or minimal effect in perineal hidradenitis suppurativa. Therefore surgical excision must be considered in the early stages of the disease at this region to prevent further complications.