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. 2020 Apr;34(4):839-845.
doi: 10.1111/jdv.16135. Epub 2020 Jan 6.

Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa

L Fertitta  1 , C Hotz  1 , P Wolkenstein  1 , J P Méningaud  2 , D Sawan  2 , B Hersant  2 , E Sbidian  1
Affiliations

Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa

L Fertitta et al. J Eur Acad Dermatol Venereol. 2020 Apr.

Abstract

Background: Surgery is a radical treatment for hidradenitis suppurativa (HS) and may be considered as the only one potentially curative.

Objectives: To characterize HS recurrence in patients after surgery and assess the risk factors of recurrence.

Methods: We conducted a monocentric retrospective cohort study. All consecutive patients who had surgery (January 1, 2012 to March 31, 2017) were included. We estimated the rate of recurrence of HS lesions after surgery (<1 cm from the scar), and recurrence-associated factors were analysed by univariate then multivariate logistic regression, estimating odds ratios (ORs) and 95% confidence intervals (CIs).

Results: A total of 75 patients [median age 31.4 years (range 16-71); 36 females], corresponding to 115 interventions were included. The Hurley score at surgery was III for 70 (60%) patients. In total, 61/115 (53%) interventions involved wide excision and 50 (43%) limited local excision. The localizations were axillary folds (n = 46; 40%), buttocks (n = 15, 13%), genital area (n = 13; 11%), perineal area (n = 12; 10%) and inguinal folds (n = 18; 16%). We observed 11 (10%) complications and 40 (35%) recurrences. On multivariate analysis, probability of recurrence was associated with only one-stage surgical closure [OR 3.2 (95% CI 1.4-7.3), P = 0.005]. Overall, 44 (52%) patients were completely satisfied and 22 (26%) partially satisfied, and most (81%) considered the surgery the best treatment.

Conclusions: Hidradenitis suppurativa recurrence in our study was 35% and associated with one-stage surgical closures, but two-thirds of patients were satisfied with surgical treatment and would recommend surgery.

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References

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