HIDRADENITIS SUPPURATIVA: A CASE SERIES OF EIGHT PATIENTS

Hidradenitis suppurativa is a persistent, inflammatory and recurrent disease of the hair follicles which, in time, results in ugly scars. Inflammation and obstruction of channel of sweat glands used to be thought to be the basis of this disease.

This paper presents the cases of 8 patients operated on in the past 3 years. A possibility of an oversight in making the diagnosis, as well as an underestimation in the treatment should be taken into consideration. In addition to surgical methods the authors discuss other therapeutic possibilities taken from the available literature. This is a retrospective analysis of the surgical findings. The treatment was multidisciplinary but the surgical excision was the only option which provided healing without recurrence so far. In our series the excision could be done to the fascia or to leave a thin layer of adipose tissue. The reconstruction could be achieved by healing per secundam, by autologous skin or artificial graft, or by narrowing the wound with a skin portion. Our results achieved by stage, secondary stitches and rotation portions were satisfying.

In case of advanced disease only surgery can lead to healing. We performed late surgery because the disease was diagnozed in advanced stages according to Hurlay. Wide excision was done in all our patients. The reconstruction was achieved with rotational flap in 3 patients, the wound healing per secundam in 4 patients and with primary suture in one patient. Our patients did not have recurrences of the primary disease. The disease was combined in one case with perianal fistula.