Surgical treatment of extensive perianal hidradenitis
Authors:
V. Kocinec 1; A. Bártlová 2; M. Salavec 2; S. Jackanin 3; L. Havrlentová 3; J. Örhalmi 1; Z. Šerclová 1
Authors place of work:
Chirurgické oddělení Nemocnice Hořovice, Hořovice
1; Dermatovenerologická klinika Fakultní nemocnice Hradec Králové a Lékařské fakulty Univerzity Karlovy, Hradec Králové
2; Chirurgické oddělení Vítkovické nemocnice, a. s., Vítkovice
3
Published in the journal:
Rozhl. Chir., 2020, roč. 99, č. 9, s. 408-412.
Category:
Case Report
doi:
https://doi.org/10.33699/PIS.2020.99.9.409–413
Summary
Introduction: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurative, and fistulising disease of apocrine glands, adjacent anal canal and soft tissues. Perianal area is the second most common affected area after axilla. There are three grades of the disease. Hidradenitis suppurativa represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses, followed by the formation of sinus tracts and subsequent scarring. Perianal hidradenitis suppurativa is the last and the most serious grade of the disease and a specific access is needed for patient preparation and surgical treatment alone. The currently preferred method of treatment for patients with extensive perianal hidradentitis is excision and closure with combination of skin flaps, primary suture and skin graft in one or two stages.
Case reports: There are three case reports of perianal hidradenitis suppurativa in this article. The local and overall initial treatment of patients followed by a radical excision and closure with a rotation skin flaps and skin grafts is described. The final results were satisfactory, with no recurrence or serious complication.
Keywords:
perianal hidradenitis suppurativa – Verneuil disease – rotation flap – skin graft
Zdroje
- Zouboulis CC, Desai N, Emtestam L, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015;29(4):619−644. doi:10.1111/jdv.12966.
- Mortimer PS. Hidradenitis suppurativa. Journal of the Royal Society of Medicine 2000;93(8):420−422. doi:10.1177/014107680009300808.
- Bell BA, Ellis H, Hidradenitis suppurativa. Journal of the Royal Society of Medicine 1978;71(7):511−516.
- Brown TJ. Hidradenitis suppurativa. The Southern Medical Journal 1998;98(12):1107−1114. doi:10. 1097/00007611-199812000-00003.
- Von der Werth J. Hidradenitis suppurativa. Dermatology in Practice 2001;9(3):22−25.
- Liron-Ruiz R, Torralba-Martinez JA, Pellicer-Franco J, et al. Treatment of long-standing extensive perianal hidradenitis suppurativa using double rotation plasty, V-Y plasty and free grafts. International Journal of Colorectal Disease 2004;19(1):73−78. doi: 10.1007/s00384-003-0518-8.
- Church JM. The differential diagnosis and comorbidity of hidradenitis suppurativa and perianal Crohn‘s disease. International Journal of Colorectal Disease 1993;8 (3):117−119. doi:10.1007/BF00341181.
- Seyed Jafari SM, Knüsel E, Cazzaniga S, et al. Retrospective cohort study on patients with hidradenitis suppurativa. Dermatology 2018;234(1−2):71−78. doi:10.1159/000488344.
- Boer J, Jemec GB. Mechanical stress and the development of pseudo-comedones and tunnels in Hidradenitis suppurativa/Acne inversa. Exp Dermatol. 2016;25(5):396−397. doi:10.1111/exd.12926.
- Byrd AS, Carmona-Rivera C, O‘Neil LJ, et al. Neutrophil extracellular traps, B cells, and type I interferons contribute to immune dysregulation in hidradenitis suppurativa. Sci Transl Med. 2019;11(508): eaav5908. doi:10.1126/scitranslmed. aav5908.
- Langerová E. Acne tetrada a možnosti biologické léčby. Dermatol Praxi 2014;8:11−14.
- Zouboulis CC, Bechara FG, Dickinson-Blok JL, et al. Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group. J Eur Acad Dermatol Venereol. 2019;33(1):19−31. doi:10.1111/jdv.15233.
- Mahmoud BH, Tierney E, Hexsel CL, et al. Prospective controlled clinical and histopathologic study of hidradenitis suppurativa treated with the long-pulsed neodymium:yttrium-aluminium-garnet laser. J Am Acad Dermatol. 2010;62(4):637−645. doi:10.1016/j.jaad.2009.07.048.
- van der Zee HH, Prens EP, Boer J. Deroofing: a tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions. J Am Acad Dermatol. 2010;63(3):475−480. doi:10.1016/j.jaad.2009.12.018
- Janse IC, Hellinga J, Blok JL, et al. Skin-tissue-sparing excision with electrosurgical peeling: A case series in hidradenitis suppurativa. Acta Derm Venereol. 2016;96(3):390−391. doi:10.2340/00015555-2258.
- Endo Y, Tamura A, Ishikawa O, et al. Perianal hidradenitis suppurativa: early surgical treatment gives good results in chronic or recurrent case. British Journal of Dermatology 1998;139(5):906−910. doi:10.1046/j.1365-2133.1998.02524.x.
- Blok JL, Spoo JR, Leeman FW, et al. Skin-tissue-sparing excision with electrosurgical peeling (STEEP): a surgical treatment option for severe hidradenitis suppurativa Hurley stage II/III. J Eur Acad Dermatol Venereol. 2015;29(2):379−382. doi:10.1111/jdv.12376.
- Alharbi Z, Kauczok J, Pallua N. A review of wide surgical excision of hidradenitis suppurativa. BMC Dermatol 2012; 12(9):9. [Online] [cit. 2020-06-01]. Available at: https://bmcdermatol.biomedcentral.com/articles/10.1186/1471-5945-12-9 doi:10.1186/1471-5945-12-9.
- Bocchini SF, Habr-Gama A, Kiss DR, et al. Gluteal and perianal hidradenitis suppurativa: surgical treatment by wide excision. Disease of the colon and rectum 2003;46(7):944−949. doi:10.1007/s10350-004-6691-1.
- Suppa M, D‘Hondt V, Daxhelet M, et al. Step by step surgery: a new therapeutic proposal for hidradenitis suppurativa. Exp Dermatol. 2019;28(Suppl.2):5–55. doi:10.1111/exd.13893.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2020 Číslo 9
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
- Surgical treatment of extensive perianal hidradenitis
- Incarcerated lumbar hernia in the Petit´s triangle as a cause of large bowel obstruction
- Changes in normothermia during surgery
- Extensive bile duct injury resulting from a laparoscopic cholecystectomy resolved by a Roux-en-Y tri-hepaticojejunostomy: a case report