Surgical Management of Hidradenitis Suppurativa: A Hospital Experience in Rwanda

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent painful nodules, abscesses, and sinus tract formation. This condition is more prevalent in individuals with darker skin tones and is often underreported in Africa, thus limiting the availability of regional treatment data. We report the case of a 24-year-old man in Rwanda who presented with refractory HS affecting the perineum and the axillae. The patient underwent wide subfascial excision. The perineal wounds were left to heal by secondary intention through wound contraction, whereas the axillary wounds were covered with skin grafts. Postoperative care included antibiotics and sitz baths, which resulted in satisfactory wound healing despite a brief recurrence. This case underscores the effectiveness of wide excision with secondary healing for perineal wounds and skin grafting for axillary wounds as a viable treatment strategy for severe HS in a low-resource setting. The need for further research focusing on HS in African populations is highlighted.