The role of wide local excision for the treatment of severe hidradenitis suppurativa (Hurley grade III): Retrospective analysis of 74 patients

Posch, Christian; Itzinger-Monshi, Babak; Quint, Tamara; Vujic, Igor; Lilgenau, Nikolaus; Rappersberger, Klemens

doi:10.1016/j.jaad.2017.01.055

Cited by 55 publications

(55 citation statements)

References 34 publications

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“…However, among our patients, surgical intervention resulted to be the most effective treatment strategy. In similar studies, surgery was also regarded as one of the most efficient treatments for intractable HS, which resulted in long-term local disease control and substantially improved quality of life [10, 36]. …”

Section: Discussionmentioning

confidence: 99%

A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa

et al. 2018

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Background: Hidradenitis suppurativa (HS) is one of the most distressing conditions observed in dermatology and has a substantial negative effect on the quality of life of affected persons. Objectives: The aim of this study was to evaluate different treatment strategies in patients with HS. Methods: In a retrospective cohort, all patients with HS (July 2015 to March 2017) were reviewed. Collected data consisted of patients’ demographics, clinical characteristics, psychosocial situation, and previous and current treatments. In addition, therapy response to the most recent prescribed treatments was assessed. Results: 102 patients (38 females, 64 males; median age 37.5 years) were included in this study. 68.4% of patients had BMI ≥25, and 76.5% of patients were current smokers. Hurley stages I, II, and III were detected in 13.5, 53.1, and 33.3% of patients, respectively. The most commonly administered treatments were surgery (67.6%), nonantibiotic topical therapies (72.5%), antibiotic topical therapies (55.9%), systemic antibiotics (88.2%), and biologics in 11.8% of the patients. 84.6% of the patients showed a response (27.5 and 47.1% partial and complete response, respectively) to the treatments. Conclusion: HS as a chronic, recurrent inflammatory skin disease is associated with smoking and obesity. Application of systemic antibiotics is the most frequent treatment strategy for this disease. However, surgical intervention seems to be the most effective treatment strategy.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa

et al. 2018

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“…We identified seven clinical trials of infliximab, 23-29 six of adalimumab, [30][31][32][33][34][35] three of etanercept 22,36,37 and two of ustekinumab. 38,39 There were five publications on surgical treatment, [40][41][42][43][44] one study on combination of surgical treatment with photodynamic therapy 45 and two other studies on photodynamic therapy. 46,47 There were three studies on antibiotics, [48][49][50] single studies on metformin, 51 PUVA, 52 hyperbaric oxygen therapy, 53 alitretinoin, 54 acitretin, 55 ankinra, 56 apremilast, 57 oral zinc gluconate combined with topical triclosan 58 and verapamil.…”

Section: Clinical Trials In Hsmentioning

confidence: 99%

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Chernyshov

Zouboulis

Tómas-Aragonés

et al. 2019

Acad Dermatol Venereol

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This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient‐Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS‐specific health‐related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high‐quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double‐blind randomized placebo‐controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well‐designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long‐term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS‐specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology‐specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS‐specific, dermatology‐specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient‐Oriented Outcomes.

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“…Different observational studies have evaluated the recurrence risk, which seemed to be mainly associated with the type of surgery (Table S2, Supporting Information [6][7][8][9][10][11][12][13][14][15][16][17][18][19] ). The recurrence risk after wide excision was estimated at 6-38% 9,18 with very different sample sizes (from 17 to 117 patients 13,17 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa

Fertitta

Hotz

Wolkenstein

et al. 2020

Acad Dermatol Venereol

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Background Surgery is a radical treatment for hidradenitis suppurativa (HS) and may be considered as the only one potentially curative. Objectives To characterize HS recurrence in patients after surgery and assess the risk factors of recurrence. Methods We conducted a monocentric retrospective cohort study. All consecutive patients who had surgery (January 1, 2012 to March 31, 2017) were included. We estimated the rate of recurrence of HS lesions after surgery (<1 cm from the scar), and recurrence‐associated factors were analysed by univariate then multivariate logistic regression, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 75 patients [median age 31.4 years (range 16–71); 36 females], corresponding to 115 interventions were included. The Hurley score at surgery was III for 70 (60%) patients. In total, 61/115 (53%) interventions involved wide excision and 50 (43%) limited local excision. The localizations were axillary folds (n = 46; 40%), buttocks (n = 15, 13%), genital area (n = 13; 11%), perineal area (n = 12; 10%) and inguinal folds (n = 18; 16%). We observed 11 (10%) complications and 40 (35%) recurrences. On multivariate analysis, probability of recurrence was associated with only one‐stage surgical closure [OR 3.2 (95% CI 1.4–7.3), P = 0.005]. Overall, 44 (52%) patients were completely satisfied and 22 (26%) partially satisfied, and most (81%) considered the surgery the best treatment. Conclusions Hidradenitis suppurativa recurrence in our study was 35% and associated with one‐stage surgical closures, but two‐thirds of patients were satisfied with surgical treatment and would recommend surgery.

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The role of wide local excision for the treatment of severe hidradenitis suppurativa (Hurley grade III): Retrospective analysis of 74 patients

Cited by 55 publications

References 34 publications

A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa

A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa

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