[Acne inversa (hidradenitis suppurativa)]

Area of Science:

• Dermatology
• Inflammatory Skin Diseases

Background:

• Hidradenitis suppurativa (acne inversa) is a chronic inflammatory follicular skin disease.
• It leads to debilitating fistulae, abscesses, and scarring, with Stage III (Hurley classification) representing extensive, disfiguring lesions.

Purpose of the Study:

• To review current conservative and surgical treatment strategies for hidradenitis suppurativa.
• To discuss preoperative and postoperative approaches for tissue preservation and recurrence prevention.

Main Methods:

• Literature review of conservative treatments including topical clindamycin, systemic antibiotics (clindamycin, rifampicin), anti-TNF antibodies, and laser epilation.
• Analysis of surgical mainstays: complete excision of fistulae with potential plastic coverage.
• Discussion of adjunctive strategies for tissue management and recurrence prevention.

Main Results:

• Conservative options provide symptomatic relief and disease management.
• Surgical excision remains crucial for extensive disease, often requiring reconstructive techniques.
• Pre- and postoperative care are vital for optimizing outcomes and reducing recurrence rates.

Conclusions:

• Effective management of hidradenitis suppurativa involves a multimodal approach.
• Tailoring treatment to disease severity (Hurley stage) is essential.
• Minimizing tissue loss and implementing recurrence prevention strategies are key to long-term patient well-being.