Predictors for Remission Versus Refractory Disease Following Wide Local Excision Surgery for Hidradenitis...

Area of Science:

• Dermatology
• Surgical Oncology
• Psychiatry

Background:

• Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with substantial psychosocial impact.
• Skin of color (SOC) populations are underrepresented in HS research, particularly concerning post-surgical outcomes.
• Predictors of HS recurrence after surgical excision are not well understood.

Purpose of the Study:

• To identify non-surgical risk factors for persistent, refractory HS despite medical and surgical interventions in a predominantly SOC population.
• To analyze predictors of disease remission versus refractoriness following surgical excision for HS.

Main Methods:

• Retrospective chart review of 31 adult HS patients with prior excision surgery.
• Patients categorized into remission (n=15) or refractory (n=16) cohorts based on post-surgical outcomes.
• Extraction of demographic, clinical, and surgical data from electronic medical records.

Main Results:

• Active smoking at surgery (68.8% vs. 33.3%) and groin/perineal involvement (p=0.0059; p=0.0185) were associated with refractory HS.
• Psychiatric comorbidities were more frequent in the refractory group (75% vs. 33.3%).
• Female patients with gynecological comorbidities or hormone dysregulation showed higher remission rates (p=0.0024).

Conclusions:

• Active cigarette smoking and specific anatomical involvement (groin/perineal) are significant predictors of HS refractoriness post-surgery.
• Screening for psychosocial burden is crucial, as refractory HS patients may have higher rates of comorbid psychiatric illness.
• The role of female hormone dysregulation in HS pathophysiology and surgical outcomes warrants further investigation.