Recurrence after surgical treatment of hidradenitis suppurativa.

Abstract

From six to 89 months after surgery 82 patients who had been treated by radical surgery (118 excisions) for intractable hidradenitis suppurativa were reviewed. Local recurrence rates varied greatly with the disease site, being low after axillary (3%) and perianal surgery (0%) and high after inguinoperineal (37%) and submammary (50%) excision. Recurrence results from inadequate excision or an unusually wide distribution ofapocrine glands, but physical factors such as obesity, local pressure, and skin maceration played a part in a few patients. Recurrence due to inadequate surgery tended to be the most troublesome. At follow up 75 (91%) ofthe patients were pleased with the results of their operation. A quarter of the patients developed disease at a new anatomical site after operation.Radical surgery gives good symptomatic control of severe hidradenitis suppurative of the axilla, inguinoperineal, and perianal regions but is less satisfactory for submammary disease.

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

“…Watson [139] noted the need for reoperation in approximately 20% of patients with inguinal disease whether they were treated with excision and primary closure or excision and skin grafting. Harrison et al [124] reported a 37% recurrence rate of inguinoperineal disease after wide excision without skin grafting. However, Ariyan and Krizek [140] and Thornton and Abcarian [141] recommended excision and secondary healing for patients with more extensive inguinoperineal and/or perianal-perineal disease, respectively, noting that the need for colostomy was rare.…”

“…When surgeons are uncertain about the extent of the disease, preoperative magnetic resonance imaging or ultrasound can be used. Alternatively, intraoperative color marking of sinus tracts with dyes such as methyl violet and iodine starch can be used to define the operative area [117,124,125]. …”

Acne inversa – Interdisziplinäre Leitlinien der Deutschen Dermatologischen Gesellschaft – Berufsverband der Deutschen Dermatologen e. V., Subkommission Proktologie

“…Da mit den regionären Lappenplastiken wiederum haartragende Haut, von der eine Neuerkrankung ausgehen kann, an die vormals erkrankte Stelle kommt, ist mit Rezidiven zu rechnen. Harrison et al [27] beobachteten aber auch ein Wiederauftreten nach radikaler Operation mit sekundärer Wundheilung. 6 Monate bis zu 7,5 Jahre nach Operation sahen sie in ihrem Kollektiv von 82 Patienten perianal keine, axillär in 5%, inguinal in 37% und submammär sogar in 50% der Fälle Rezidive.…”

The Broad-Spectrum Impact of Hidradenitis Suppurativa on Quality of Life: A Comparison with Psoriasis

“…First, its prevalence is still uncertain. It has been estimated to occur in a range from less than 0.1 [2-4] up to 2 [5], 4 [6], or even 8% [7]. Also, patients with HS have been treated by many different medical specialties, but by none of them in particular.…”

“…Also, patients with HS have been treated by many different medical specialties, but by none of them in particular. This decentralization of care has resulted in a significant diagnostic delay of 5–14 years [7], causing an increased burden for the patients. Because of its comorbidities, including the metabolic syndrome, autoimmune diseases marked by systemic inflammation, such as Crohn’s disease, and the stigma and pain [8] that it causes, it has often been compared to psoriasis [9].…”