PERIANAL HIDRADENITIS SUPPURATIVA - EARLY SURGICAL-TREATMENT GIVES GOOD RESULTS IN CHRONIC OR RECURRENT CASES

Hidradenitis suppurativa (IIS) represents a chronic, recurrent, deep-s eated folliculitis resulting in abscesses followed by the formation of sinus tracts and scarring. II is an uncommon disorder frequently invo lving the perianal region. We review the clinical and pathological fea tures of 12 patients (10 men and two women) with perianal HS (PHS). Th e mean age at presentation was 43 years (range 24-65), and the mean du ration of illness was 14 years (range 2-30). Two patients exhibited mu ltiple areas of involvement, including the axilla and the nape of the neck, in addition to the perianal region. Histological examinations sh owed epidermis-lined sinuses surrounded by dense plasma cell infiltrat ion in four of nine specimens. The complications related with PHS incl uded anal fistula (seven patients), diabetes mellitus (four), malignan t tumour (two) and sepsis (one). Three patients died of the complicati ons. Eight patients underwent wide local excision. The defects were ma naged with a meshed split-thickness skin graft in five patients, and o pen treatment in the remainder. New lesions developed in untreated ski n of two patients. However, no patient, relapsed in the surgically tre ated sites. PHS is frequently complicated with anal fistula and is occ asionally life-threatening as a result of the occurrence of malignant tumours or sepsis. Early surgical excision followed by meshed split-th ickness skin graft can successfully cure the lesion without; functiona l disturbance.