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Surgeries in hidradenitis suppurativa

WCD 2019

There are many efficacious surgical options for hidradenitis suppurativa (HS), mostly needing long wound care and a committed patient.

Mostly, stage 3 HS is when surgery is discussed, but it can be also an option in solitary lesions [1]. “Surgery should definitely be considered in diffuse or nearly diffuse areas, unresponsive lesions with failed topical or systemic therapy, and in the case of considerable scarring,” explained Dr Stanislav Tolkachjov (Mohs Surgery, USA). Possible good choices for HS are deroofing/unroofing, skin tissue-saving excision with electrosurgical peeling (STEEP), and wide surgical excision (WLE) [1]. Before deciding on surgery, the patient needs to understand that the disease can recur and has to be willing to go through long-term wound care and potential multiple procedures. In extensive gluteal disease, a diverting ostomy might facilitate difficult wound care.

Deroofing is a surgical option that can be done by the dermatol...

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