The distribution, size and density of the apocrine glands in hidradenitis suppuritiva as compared with those in axillary hyperhidrosis and normal controls have been studied. There are no significant differences in the size or density of the apocrine glands in hidradenitis suppuritiva as compared with normal controls. The apocrine glands in axillary hyperhidrosis are significantly larger than those in axillary hidradenitis and in normal controls. A simple method that can be used to demonstrate the distribution of the apocrine glands preoperatively is described. This has proved useful in delineating the area which it is necessary to excise to obtain complete apocrine gland excision in the diseased area. The apocrine gland-containing skin in the diseased region does not always correspond exactly to the hair-bearing area in that region.

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Three cases of inflammatory duct ectasia occurring in the male breast are described. The clinical presentation of the disease in the male closely resembles that in the female. Nipple retraction, nipple discharge, periareolar inflammation and bilateral involvement are all seen. Conservation measures produced unsatisfactory results similar to those in women. A similar operative approach to that used in women is advocated.

We describe our experience in the use of a Silastic foam dressing in I7 patients undergoing radical excision of hidradenitis suppurativa whose wounds were allowed to heal by granulation. Axillary excisions were carried out in 9 patients and perineal excisions in 8 patients. The technique permits adequate excision of the disease and results in a cosmetically acceptable scar, superior to that obtained by skin grafting and with little limitation of movement. It avoids the pain of conventionalmanagement of granulating wounds by gauze packing.It is considered that this method of management is superior in most respects to other techniques used to manage the defect resulting from adequate excision of hidradenitis.

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