Dermatologic surgeryDeroofing: A tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions
Section snippets
Methods
In all, 44 consecutive patients with HS were treated in an open trial with the deroofing technique in the outpatient Department of Dermatology, Deventer Hospital, The Netherlands, in the period 2003 to 2007. The criteria used to establish the diagnosis of HS were: presence of typical lesions (ie, deep-seated painful nodules, abscesses, draining sinuses, bridged scars, and “tombstone” open comedones in secondary lesions); typical topography (ie, axillae, groin, perineal and perianal region,
Results
In all, 44 patients with HS, 3 male and 41 female, with a total of 88 lesions underwent deroofing during the investigated period. No deroofed cases were excluded from the study. Patient characteristics are given in Table I. All patients had a history of active long-standing HS. The median age of disease onset was 28 years. The median age at time of deroofing was 35 years with a median body mass index of 26.8.
Lesion characteristics are given in Table II. Most of the deroofed lesions (41 [47%])
Discussion
The treatment repertoire for HS consists of medical (topical, systemic) and surgical interventions. Early intervention is considered mandatory to prevent disease activity from getting out of control with consequences such as fibrosis, scarring, and sinus tract formation causing therapy resistance and major quality-of-life impairment. Several surgical interventions have been described for HS often with considerable recurrence rates. The reported recurrence rates after incision with drainage are
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A simple video demonstrating the deroofing technique for hidradenitis suppurativa
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2022, Journal of Emergency MedicineCitation Excerpt :Emergency or urgent care physicians familiar with how to punch deroof HS lesions may employ this technique for recurrent abscesses, which requires more time than I&D, but has a lower risk of recurrence (21). The skin overlying a recurrent nodule or abscess is incised with a punch tool, then the purulent or gelatinous material within is removed, either with direct pressure or using a curette, and the site is allowed to heal by means of secondary intention (21–23). Continuing medical therapy, which may include antibiotics or biologic therapies, during the perioperative period may be associated with reduced recurrence risk (24).
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Conflicts of interest: None declared.