Learning Objectives:
After studying this article, the participant should be able to: 1. Describe the pathogenesis of hidradenitis suppurativa. 2. Discuss perioperative multimodal therapy of hidradenitis suppurativa, including medical optimization. 3. Determine an appropriate surgical plan with excision and reconstruction based on hidradenitis suppurativa severity, size, and anatomical location.
Summary:
Successful treatment of hidradenitis suppurativa requires a multidisciplinary team approach and multimodal therapy.
Hidradenitis suppurativa is a debilitating chronic inflammatory condition of the folliculopilosebaceous units, characterized by nodules, scars, abscesses, and sinus tracts in areas such as the axillae, groin, perineum, and gluteal and pannicular areas. 1 Studies have demonstrated the condition's devastating impact on the patient's quality of life, sometimes leading to clinical depression. Hidradenitis suppurativa is associated with lifestyle factors such as smoking and medical comorbidities such as obesity, diabetes, polycystic ovarian syndrome, and inflammatory bowel disease. 2 The Hurley staging system describes hidradenitis suppurativa disease severity, ranging from mild disease with nodules and abscesses (stage I) to severe disease with widespread scars and sinus tract formation (stage III). 3 Despite the availability of pharmacologic agents for hidradenitis suppurativa-including antibiotics, steroids, and
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