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Gluteal and Perianal Hidradenitis Suppurativa

Surgical Treatment by Wide Excision

  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Hidradenitis suppurativa is a chronic inflammatory disease of the skin and subcutaneous tissue. Extensive gluteal and perianal disease represents a challenge presentation. The aim of this study was to present results of management of extensive hidradenitis suppurativa in gluteal, perineal, and inguinal areas. METHODS: From January 1980 to May 2000, 56 patients underwent treatment of hidradenitis suppurativa in gluteal, perineal, and inguinal areas through wide excision; 52 (93 percent) were male and 36 (64 percent) were white. Mean age was 40 years. We evaluated distribution of disease, associated conditions, use of diverting colostomy, management of operative wounds, time to complete healing, complications, and recurrence. RESULTS: Twenty-one (37.6 percent) and 17 (30.6 percent) patients had gluteal and perineal disease, respectively. Squamous-cell carcinoma and Crohn’s disease were observed in one patient each. Wide surgical excision was performed in all. Healing by second intention was the choice in 32 (57.1 percent) patients, and 24 (42.9 percent) patients underwent delayed skin-grafting. Diverting colostomy was used in 23 (41 percent) patients. Mean time for complete healing in the nongrafted group was 10 (range, 7–17) weeks and in the skin graft group was 6 (range, 3–9) weeks. New resection was performed in five (8.9 percent) patients. Partial graft loss rate was 37.5 percent and recurrence was observed in only one (1.8 percent) patient. CONCLUSION: Significant morbidity derives from extensive gluteal and perineal hidradenitis suppurativa caused by the disease extension and large wounds that result from surgical treatment. Wide surgical excision is the treatment of choice and leads to cure. Skin-grafting and healing by second intention lead to effective wound healing.

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References

  1. RW Parks TG Parks (1997) ArticleTitlePathogenesis, clinical features and management of hidradenitis suppurativa Ann R Coll Surg Engl 79 83–89

    Google Scholar 

  2. GB Jemec U Hansen (1996) ArticleTitleHistology of hidradenitis suppurativa J Am Acad Dermatol 34 994–999

    Google Scholar 

  3. AS Highet RE Warren AJ Weekes (1988) ArticleTitleBacteriology and antibiotic treatment of perineal suppurative hidradenitis Arch Dermatol 124 1047–1051

    Google Scholar 

  4. I Brook EH Frazier (1999) ArticleTitleAerobic and anaerobic microbiology of axillary hidradenitis suppurativa J Med Microbiol 48 103–105

    Google Scholar 

  5. WP Morgan G Leicester (1982) ArticleTitleThe role of depilation and deodorants in hidradenitis suppurativa Arch Dermatol 118 101–102

    Google Scholar 

  6. JS Fitzsimmons PR Guilbert EM Fitzsimmons (1985) ArticleTitleEvidence of genetic factors in hidradenitis suppurativa Br J Dermatol 113 1–8

    Google Scholar 

  7. OS Mortimer RP Dawber MA Gales RA Moore (1986) ArticleTitleA double-blind controlled cross-over trial of ciproterone acetate in females with hidradenitis suppurativa Arch Dermatol 115 263–268

    Google Scholar 

  8. RS Sawers VA Randall FS Ebling (1986) ArticleTitleControl of hidradenitis suppurativa in women using combined antiandrogen (ciproterone acetate) and oestrogen therapy Br J Dermatol 115 269–274

    Google Scholar 

  9. B Golcman P Tuma Junior GT Bonamichi JC de Faria R Golcman MC Ferreira (1991) ArticleTitleSurgical treatment of hidradenitis suppurativa [in Portuguese] Rev Hosp Clin Fac Med Univ S Paulo 46 141–144

    Google Scholar 

  10. GA Knaysi SuffixJr B Cosman GF Crikelair (1968) ArticleTitleHidradenitis suppurativa JAMA 203 19–22

    Google Scholar 

  11. DE Barros MS Resende EJO Macedo (1988) ArticleTitleTratamento cirúrgico da hidradenite supurativa perianal Rev Bras Colo-proctol 8 98–101

    Google Scholar 

  12. O Wiltz DJ Schoetz SuffixJr JJ Murray PL Roberts JA Coller MC Weidenheimer (1990) ArticleTitlePerianal hidradenitis suppurativa. The Lahey Clinic experience Dis Colon Rectum 33 731–734

    Google Scholar 

  13. JM Church VW Fazio IC Lavery JR Oakley JW Milsom (1993) ArticleTitleThe differential diagnosis and comorbidity of hidradenitis suppurativa and perianal Crohn’s disease Int J Colorectal Dis 8 117–119

    Google Scholar 

  14. IA Rosner DE Richter TL Huettner (1982) ArticleTitleSpondyloarthropaty associated with hidradenitis suppurativa and acne conglobata Ann Intern Med 97 520–525

    Google Scholar 

  15. J Kenik J Hurley (1985) ArticleTitleArthritis occurring during hidradenitis suppurativa J Rheumatol 112 183–184

    Google Scholar 

  16. C Paletta MJ Jurkiewicz (1987) ArticleTitleHidradenitis suppurativa Clin Plast Surg 14 383–390

    Google Scholar 

  17. JR Rogin H Pinkus (1948) ArticleTitleCushing’s syndrome with hidradenitis suppurativa Arch Dermatol Syph 58 746–747

    Google Scholar 

  18. SB Black JE Woods (1982) ArticleTitleSquamous cell carcinoma complicating hidradenitis suppurativa J Surg Oncol 19 25–26

    Google Scholar 

  19. B Cricx MN Dontenwille M Grossin (1983) ArticleTitleCarcinome epidermoide sur maladie de verneuil Ann Dermatol Venereol 110 705–26

    Google Scholar 

  20. LS Zachary MC Robson N Rachmaninoff (1987) ArticleTitleSquamous cell carcinoma occurring in hidradenitis suppurativa Ann Plast Surg 18 71–73

    Google Scholar 

  21. HA Brunsting (1939) ArticleTitleHidradenitis suppurativa Arch Dermatol Syph 39 108–120

    Google Scholar 

  22. FL Meleney BA Johnson (1937) ArticleTitleFurther laboratory and clinical experiences in the treatment of chronic, undermining, burrowing ulcers with zinc peroxide Surgery 1 169–221

    Google Scholar 

  23. GB Jemec M Faver E Gutschik P Wendelboe (1996) ArticleTitleThe bacteriology of hidradenitis suppurativa Dermatology 193 203–206

    Google Scholar 

  24. TJ Brown T Rosen IF Orengo (1998) ArticleTitleHidradenitis suppurativa South Med J 12 1107–1114

    Google Scholar 

  25. I Zeligman (1965) ArticleTitleTemporary X-ray epilation therapy of chronic axillary hidradenitis suppurativa Arch Dermatol 92 690–694

    Google Scholar 

  26. DW Kress WP Graham TS Davis SH Miller (1981) ArticleTitleA preliminary report on the use of staphage lysate for treatment of hidradenitis suppurativa Ann Plast Surg 6 393–395

    Google Scholar 

  27. CH Dicken ST Powell KL Spear (1984) ArticleTitleEvaluation of isotretinoin treatment of hidradenitis suppurativa J Am Acad Dermatol 11 500–502

    Google Scholar 

  28. JF Norris WJ Cunliffe (1986) ArticleTitleFailure treatment of familial widespread hidradenitis suppurativa with isotretinoin Clin Exp Dermatol 2 579–583

    Google Scholar 

  29. J Boer MJ Van Germet (1999) ArticleTitleLong-term results of isotretinoin in the treatment of 68 patients with hidradenitis suppurativa J Am Acad Dermatol 40 73–76

    Google Scholar 

  30. DH McDaniel WA Welton (1984) ArticleTitleFurunculosis and hidradenitis suppurativa response Arch Dermatol 120 437–76

    Google Scholar 

  31. DA Buckley S Rogers (1995) ArticleTitleCyclosporine-responsive hidradenitis suppurativa J R Soc Med 88 289–290

    Google Scholar 

  32. AK Gypta CN Ellis BJ Nickoloff (1990) ArticleTitleOral cyclosporine in the treatment of inflammatory and non-inflammatory dermatosis Arch Dermatol 126 339–350

    Google Scholar 

  33. GB Jemec (1988) ArticleTitleEffect of localized surgical excisions in hidradenitis suppurativa J Am Acad Dermatol 18 1103–1107

    Google Scholar 

  34. WP Chalfant FC Nance (1970) ArticleTitleHidradenitis suppurativa of the perineum Am Surg 36 331–334

    Google Scholar 

  35. JC Dalrymple JM Monaghan (1987) ArticleTitleTreatment of hidradenitis suppurativa with the carbon dioxide laser Br J Surg 74 420–334

    Google Scholar 

  36. EM Finley JL Ratz (1996) ArticleTitleTreatment of hidradenitis suppurativa with carbon dioxide laser excision and second intention healing J Am Acad Dermatol 34 465–469

    Google Scholar 

  37. J Lapins JA Marcusson L Emtestam (1994) ArticleTitleSurgical treatment of chronic hidradenitis suppurativa with CO2 laser stripping—secondary intention technique Br J Dermatol 131 551–556

    Google Scholar 

  38. S Ariyan TJ Krizek (1976) ArticleTitleHidradenitis suppurativa of the groin, treated by excision and spontaneous healing Plast Reconstr Surg 58 44–47

    Google Scholar 

  39. B Silverberg CE Smootm SJ Land RW Parsons (1987) ArticleTitleHidradenitis suppurativa Plast Reconstr Surg 79 555–559

    Google Scholar 

  40. Y Endo A Tamura O Ishikawa Y Miyachi (1998) ArticleTitlePerianal hidradenitis suppurativa Br J Dermatol 139 906–910

    Google Scholar 

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Authors and Affiliations

    Authors
    1. Sylvio F. Bocchini M.D.
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    2. Angelita Habr-Gama M.D.
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    3. Desidério R. Kiss M.D.
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    4. Antonio R. Imperiale M.D.
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    5. Sergio E. A. Araujo M.D.
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    Bocchini, S.F., Habr-Gama, A., Kiss, D.R. et al. Gluteal and Perianal Hidradenitis Suppurativa. Dis Colon Rectum 46, 944–949 (2003). https://doi.org/10.1007/s10350-004-6691-1

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    • DOI: https://doi.org/10.1007/s10350-004-6691-1

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