Radical resection and local coverage of hidradenitis suppurativa - acne inversa: analysis of results

Mendes, Rogério Rafael da Silva; Zatz, Rafael Ferreira; Modolin, Miguel; Busnardo, Fábio de Freitas; Gemperli, Rolf

doi:10.1590/0100-6991e-20181719

Cited by 5 publications

(10 citation statements)

References 29 publications

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“…Complications were seen in one third of the operative sites. However, the majority of the complications were minor and managed conservatively, similar to findings from other studies …”

Section: Discussionsupporting

confidence: 87%

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Ngaage

et al. 2019

International Wound Journal

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Wide local excision is the gold standard and only potential curative therapy for recalcitrant hidradenitis suppurativa. However, high recurrence rates persist even post-surgery with little known on the influencing factors for remission. We evaluated the effect of patient, disease, and operative factors on local cure rate of moderate to severe hidradenitis following wide local excision. We performed a retrospective chart review for all patients who had undergone surgical excision of hidradenitis at a university hospital from 2012 to 2018. We identified 79 patients with a total of 220 operative sites. The majority were obese (mean body mass index [BMI] 32.5), female (71%), African-American (84%), and had a mean age of 31 years. A quarter of operative sites experienced a recurrence (n = 56). Patients who achieved remission had a significantly lower number of affected regions than those who experienced a recurrence (2.3 vs 3.6, P = .0023). Additionally, recurrence rate differed significantly between body locations (P = .0440). Smoking, BMI, Hurley grade, closure method, and excision size did not influence local cure rate. Surgical excision remains a worthy management option for hidradenitis patients with three quarters achieving remission after a single operation. Number of affected regions and location of hidradenitis may play a factor in recurrence.

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“…Complications were seen in one third of the operative sites. However, the majority of the complications were minor and managed conservatively, similar to findings from other studies …”

Section: Discussionsupporting

confidence: 87%

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Ngaage

et al. 2019

International Wound Journal

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“…Thus, it is necessary to use a flap to close them. In axillary hidradenitis, the thoracodorsal fasciocutaneous flap is one of the most commonly performed procedures in this type of disease, but has some complications, such as seroma, dehiscence and infection 5 . New flaps should be evaluated to improve the effectiveness of hidradenitis treatment.…”

Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa: surgical treatment with latissimus dorsi muscle flap

Portella¹,

Silva²,

Castellani³

et al. 2019

Mastology

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Os autores apresentam relato de caso de um paciente do sexo feminino e com 53 anos que foi admitido no serviço de mastologia e reconstrução mamária do Hospital de Amor, de Barretos, em 2018, para tratamento de carcinoma ductal invasivo de mama direita. Durante sua admissão, o paciente queixou-se de hidradenite de axilas e virilha, sem sucesso prévio com tratamento clínico ou cirúrgico. A hidradenite é uma patologia em que ocorre inflamação crônica nas glândulas apócrinas. Diante desse quadro, foi feita a ressecção extensa das lesões axilares, e utilizou-se a mesma incisão axilar direita para a realização da setorectomia e da biópsia de linfonodo sentinela guiados por radiofármaco. Para a reconstrução axilar, optou-se pelo retalho do músculo grande dorsal bilateralmente, que resultou em ganho de qualidade de vida para a paciente. Por meio do relato do caso, os autores demonstram que, com a utilização da técnica de reconstrução mamária, tratou-se uma doença que, até o momento, não apresentava nenhuma proposta cirúrgica que não resultasse em consequências anatômicas limitantes. ABSTRACTThe authors present a case report of a 53-year-old female patient who was admitted to the mastology and breast reconstruction sector, at Barretos Cancer Hospital, in 2018, to treat an invasive ductal carcinoma in the right breast. At admission, the patient complained of hidradenitis in the armpits and groin area, with no previous success with clinical or surgical treatment. Hidradenitis is a disease in which there is chronic inflammation of the apocrine glands. With this in mind, an extensive resection of the armpit lesion was performed, and the same right armpit incision was utilized for the sectionectomy and radiopharmaceutical-guided sentinel lymph node biopsy. As for the armpit reconstruction, a bilateral latissimus dorsi flap was used, resulting in an improvement of the patient's quality of life. With this case report, the authors demonstrate that a breast reconstruction technique could be used to treat a disease that so far had no surgical solution that would not result in confining anatomic consequences for the patient.

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“…A apresentação clínica da HS inclui nódulos inflamados, abcessos e fístulas, classicamente localizado nas áreas axilar, inguinal e anogenital. [1][2][3][4][5][6] Atualmente existem vários modelos de classificação e estadiamento da doença 2,6 .…”

Section: Introductionunclassified

“…O diagnóstico é clínico com os critérios lesões típicas (nódulos inflamatórios ou não, único ou múltiplos, doloroso ou profundos, tratos sinusais (inflamatórios ou não), abscessos, comedões e/ou cicatrizes (atróficas, em malha, vermelha, hipertrófica ou linear) recorrentes dolorosas ou supurativas mais de duas vezes em seis meses; localizadas na axila, virilha, região perineal e perianal, nádegas e dobras. [1][2][3][4][5][6][7][8][9][10] Não existe exames laboratoriais específicos, a velocidade de hemossedimentação, proteína c-reativa, cultura, antibiograma, o histopatológico revela glândulas apócrinas com ductos distendidos, com linfócitos, bactérias e infiltrado celular no tecido conjuntivo periglandular e exames de imagem tal como tomografia e ressonância magnética, auxilia na definição do tratamento. 6,10 Sua natureza recorrente gera sofrimento significativo e impacto substancial na qualidade de vida do paciente.…”

Section: Introductionunclassified

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Tratamento cirúrgico de hidradenite supurativa complexa: relato de caso / Surgical treatment of complex supurative hydradenitis: case report

Pacheco¹,

Pacheco²,

Lobão³

et al. 2021

Braz. J. Hea. Rev.

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Radical resection and local coverage of hidradenitis suppurativa - acne inversa: analysis of results

Abstract: extensive and radical resection of the disease associated with locoregional flap coverage (pedicled or perforating) has been shown to be the best management in terms of late results.

Cited by 5 publications

References 29 publications

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision

Hidradenitis suppurativa: surgical treatment with latissimus dorsi muscle flap

Tratamento cirúrgico de hidradenite supurativa complexa: relato de caso / Surgical treatment of complex supurative hydradenitis: case report

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