Management of severe anogenital acne inversa (hidradenitis suppurativa).

Abstract

BACKGROUND:

Severe anogenital acne inversa (AI) is a debilitating chronic inflammatory disease with a major negative effect on quality of life.

OBJECTIVES:

To evaluate the role of surgery in the treatment of severe anogenital AI.

METHODS:

We analyzed the records of patients with anogenital AI from 2000 to 2010. Assessment was done using the Hidradenitis Suppurativa Lesion, Area, and Severity Index (HS-LASI), pain visual analogue scale, physician global assessment (PhGA), and patient global assessment (PaGA). Comorbidities and adverse events were analyzed.

RESULTS:

Sixty-seven patients with a Hurley score of 3 were identified. Mean follow-up was 56.9 ± 41.3 months. A number of comorbidities were observed. After surgery, mean pain scores decreased from 6.3 ± 1.5 to 0.8 ± 0.7, PhGA improved from 6.8 ± 1.2 to 0.9 ± 0.6, PaGA improved from 7.3 ± 1.2 to 1.1 ± 0.5, and HS-LASI decreased from 41.8 ± 21.3 to 2.4 ± 2.8. Adverse reactions were seen in 10.4%. The total relapse rate was 6% (5 patients) with only one case with healing by secondary intention (2% of 49 patients).

CONCLUSIONS:

Surgery is the cornerstone of treatment for advanced AI. Healing by secondary intention results in significant reduction of complaints and achieves satisfying body contouring.

• Authors: Uwe Wollina, Michaela Tilp, Antje Meseg, Jaqueline Schönlebe, Birgit Heinig, Andreas Nowak
• Journal: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 38 Issue 1 Pg. 110-7 (Jan 2012) ISSN: 1524-4725 [Electronic] United States
• PMID: 22092781 (Publication Type: Journal Article)
• Copyright: © 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Anal Canal
• Female
• Genitalia
• Hidradenitis Suppurativa (surgery)
• Humans
• Male
• Middle Aged
• Retrospective Studies