ABSTRACT
Hidradenitis suppurativa is a chronic inflammatory disorder of the apocrine sweat gland-bearing skin. The progressive nature of the disease can make it extremely painful and severely debilitating. Traditionally, the etiology of the disorder was believed to be occlusion of the apocrine ducts. However, recent studies suggest that follicular occlusion is the initiating event. The most common sites of the disease are the axilla, perineum, external genitalia, and inguinal regions. Medical management may afford temporary relief of symptoms; however, most patients will eventually require surgical therapy. Incision and drainage or unroofing of sinuses may provide relief in select patients but should be reserved for early and acute disease. Local excisions will provide adequate control of symptoms; however, greater than 50% recurrence can be anticipated. Wide excision with secondary granulation of perineal wounds will provide the most definitive therapy and can be accomplished safely. Perianal disease can more often be managed with local excision alone as recurrence rates of perianal disease are considerably lower than perineal disease.
KEYWORD
Hidradenitis suppurativa - Verneuil's disease - apocrine - perineal disease - perianal disease
