[Surgical therapy of the acne tetrad]

On the basis of a 3 years experience with surgical treatment of acne tetrad (acne conglobata, apocrine acne) in 22 patients, we can draw the following conclusions: 1. Radical surgical excision yields better long-term results than local incision. Recurrences are mostly the result of non-radical surgery. 2. In cases of limited acne--especially if it is localized either in the axilla or the groin--primary wound closure may be successfully attained. 3. Gentamycin chains may support the primary wound healing in defect closures of infected areas. 4. In the axilla, we suggest wound closure by myocutaneous island flaps as the best procedure after extensive excision. 5. Specific antibiotic protection, perioperatively, according to previous culture and sensitivity testing can guarantee a postoperative course free from infection. 6. Open wound therapy with secondary healing of the soft tissue defects proved to be the treatment of choice in perineal procedures. 7. In view of the poor prognosis of conservative methods in chronic acne, and because of the risk of subsequent manifestation of chronic septicemia, early surgical excision is desirable.