Fast Five Quiz: Hidradenitis Suppurativa Management

William D. James, MD


January 27, 2023

Wide surgical excision has long been considered the most definitive surgical therapy for hidradenitis suppurativa. This technique requires margins well beyond the clinical borders of activity and sufficient resection of the lesion.

Minor surgical interventions are often helpful in the management of hidradenitis suppurativa. These include drainage; exteriorization; Nd:YAG laser treatment; curettage; electrocoagulation of the sinus tracts; simple excision of affected areas with direct closure; placement of local cutaneous flaps, musculocutaneous flaps, pedicled and free flaps, or skin grafts; and secondary intention healing.

Deroofing of sinus tracts and curettage of fistulous tracts is helpful for many patients who don't yet require more definitive intervention, particularly those with recurrent lesions at early stages of the disease.

Electrosurgery is not contraindicated in hidradenitis suppurativa. It has been shown to have high success rates and is recommended as a leading treatment alternative.

Learn more about surgical interventions for hidradenitis suppurativa.


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