The authors have indicated no significant interest with commercial supporters.
Management of Severe Anogenital Acne Inversa (Hidradenitis Suppurativa)
Article first published online: 14 SEP 2011
© 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
Volume 38, Issue 1, pages 110–117, January 2012
How to Cite
Wollina, U., Tilp, M., Meseg, A., Schönlebe, J., Heinig, B. and Nowak, A. (2012), Management of Severe Anogenital Acne Inversa (Hidradenitis Suppurativa). Dermatologic Surgery, 38: 110–117. doi: 10.1111/j.1524-4725.2011.02157.x
- Issue published online: 5 JAN 2012
- Article first published online: 14 SEP 2011
Severe anogenital acne inversa (AI) is a debilitating chronic inflammatory disease with a major negative effect on quality of life.
To evaluate the role of surgery in the treatment of severe anogenital AI.
We analyzed the records of patients with anogenital AI from 2000 to 2010. Assessment was done using the Hidradenitis Suppurativa Lesion, Area, and Severity Index (HS-LASI), pain visual analogue scale, physician global assessment (PhGA), and patient global assessment (PaGA). Comorbidities and adverse events were analyzed.
Sixty-seven patients with a Hurley score of 3 were identified. Mean follow-up was 56.9 ± 41.3 months. A number of comorbidities were observed. After surgery, mean pain scores decreased from 6.3 ± 1.5 to 0.8 ± 0.7, PhGA improved from 6.8 ± 1.2 to 0.9 ± 0.6, PaGA improved from 7.3 ± 1.2 to 1.1 ± 0.5, and HS-LASI decreased from 41.8 ± 21.3 to 2.4 ± 2.8. Adverse reactions were seen in 10.4%. The total relapse rate was 6% (5 patients) with only one case with healing by secondary intention (2% of 49 patients).
Surgery is the cornerstone of treatment for advanced AI. Healing by secondary intention results in significant reduction of complaints and achieves satisfying body contouring.