BACKGROUND AND OBJECTIVES: Deroofing has proven to be an effective method to treat mild to moderate forms of hidradenitis suppurativa (HS). The basic procedure includes removal of the sinus roof, followed by secondary intention healing, while fibrotic tissue usually stays in situ. We have tried to establish a modified method of deroofing in which meticulous removal of the fibrotic tissue results in a low recurrence rate in moderate to severe HS patients. PATIENTS AND METHODS: An open prospective study consisted of 96 deroofed lesions in 52 consecutive patients with moderate to severe HS. Patients were followed up for a minimum of 28 months. RESULTS: Recurrence occurred after a median time of 2.3 months in 14 % of locations. Recurrences according to location were as follows: 6 % in the axillary region and 25 % in the inguinal region. Postoperative bleeding was the only considerable complication and occurred in 7 % of treated locations. Seven patients were lost to follow-up. CONCLUSION: Modified deroofing followed by meticulous sinus tract removal is a surgical approach suitable for patients with moderate disease, especially in the axillary region. This results in a low recurrence rate and the same healing period as that of the standard deroofing procedure.

• MeSH
• Axilla MeSH
• Surgical Procedures, Operative adverse effects   methods   MeSH
• Debridement adverse effects   methods   MeSH
• Adult MeSH
• Hidradenitis Suppurativa pathology   surgery   MeSH
• Wound Healing physiology   MeSH
• Inguinal Canal MeSH
• Humans MeSH
• Postoperative Complications epidemiology   MeSH
• Postoperative Hemorrhage epidemiology   MeSH
• Prospective Studies MeSH
• Recurrence MeSH
• Severity of Illness Index MeSH
• Lost to Follow-Up MeSH
• Visual Analog Scale MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Hidradenitis suppurativa (HS) je recidivující chronické zánětlivé onemocnění, pro které jsou typické hluboké zánětlivé bolestivé léze – noduly, abscesy, píštěle, jizvení. Predilekční lokalizací jsou axily, genitofemorální oblast, perineum, gluteální oblast, inframammární oblast u žen. Onemocnění má multifaktoriální patogenezi, uplatňuje se dědičnost, imunitní dysregulace, dále kouření a obezita. Léčba HS závisí jak na závažnosti onemocnění (hodnotí se podle Hurleyho klasifikace), tak na aktivitě onemocnění (hodnotí se pomocí HS-PGA). Léčba 1. linie zahrnuje klindamycin (lokálně), dále doxycyklin (p. o.) nebo klindamycin (p. o.) a adalimumab (s. c.). Další možností je léčba chirurgická, která zahrnuje zejména excize zánětlivých projevů, deroofing, rekonstrukce lalokovou plastikou, dále terapii CO2 laserem nebo Nd:YAG laserem, totální excizi lézí a perilezionální oblasti, širokou excizi lézí s následným hojením per secundam.

Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory disease characterized by deep painful nodules, abscesses,sinus tracts and scarring. The most common areas affected are the axillae, the groin, the buttocks, the anogenital and perinealregion, inframammary areas. Its pathogenesis is multifactorial and includes genetic aspects, immune dysregulation, smokingand obesity. The treatment of HS depends on the severity of the disease (according to Hurley classification) and on its activity(according to Physician´s Global Assessment). First-line treatment includes topical clindamycin, oral doxycyclin or oral clindamycinand adalimumab. Surgical treatment includes deroofing, incision of inflammatory lesions, reconstruction with flap plasty, carbondioxide laser therapy, Nd:YAG laser, total excision of the lesions and surrounding hair-bearing skin and second intention healing.

• MeSH
• Adalimumab therapeutic use   MeSH
• Anti-Inflammatory Agents therapeutic use   MeSH
• Hidradenitis Suppurativa * classification   physiopathology   therapy   MeSH
• Humans MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• Keywords
• chirurgická excize, deroofing sinusů a píštělí, marsupializace,
• MeSH
• Androgen Antagonists pharmacology   therapeutic use   MeSH
• Anti-Bacterial Agents * administration & dosage   pharmacology   therapeutic use   MeSH
• Administration, Topical MeSH
• Early Medical Intervention MeSH
• General Surgery * methods   MeSH
• Cyclosporine pharmacology   therapeutic use   MeSH
• Dapsone pharmacology   therapeutic use   MeSH
• Photochemotherapy MeSH
• Hidradenitis Suppurativa * history   diagnosis   epidemiology   etiology   drug therapy   classification   MeSH
• Immunosuppressive Agents * pharmacology   therapeutic use   MeSH
• Laser Therapy MeSH
• Humans MeSH
• Obesity prevention & control   MeSH
• Smoking Cessation MeSH
• Retinoids pharmacology   therapeutic use   MeSH
• Patient Education as Topic MeSH
• Check Tag
• Humans MeSH