Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa. (6th January 2020)

• Record Type: Journal Article
• Authors: Fertitta, L.; Hotz, C.; Wolkenstein, P.; Méningaud, J.P.; Sawan, D.; Hersant, B.; Sbidian, E.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 34:Number 4(2020)
• Page Start: 839
• Page End: 845
• Publication Date: 2020-01-06
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.16135
• Languages: English
• ISSNs: 0926-9959

Abstract

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.