EXTENT OF SURGERY AND RECURRENCE RATE OF HIDRADENITIS SUPPURATIVA

Hidradenitis suppurativa (HS) is a chronic fistula- and abscess-formin g disease of the cutis and subcutis of unknown etiology. Disease recur rence is frequent and may cause severe complications. We analyzed pati ents with HS who underwent surgery between 1976 and 1997. The operativ e procedures were divided into drainage procedures (n=6), limited regi onal (n=14), and radical wide excisions (n=11). The extent of surgery was examined in terms of the clinical course and late postoperative se quelae of HS, At a mean follow-up of 72 months, we found developed loc oregional recurrent HS in 45% of patients. There was 100% recurrence a fter drainage, 42.8% after limited, and 27% after radical excision (P< 0.05), EIS recurred after a median interval of 3 months for drainage, 11 months for limited excision, and 20 months for radical excision (P< 0.05). The disease-free interval continued up to 35 months. Long-term sequelae included penile amputation and a case of fatal squamous cell carcinoma. Although radical wide excision of the HS-affected cutis is associated with the lowest recurrence rate, it is still considerable a nd warrants long-term follow-up.