Extensive hidradenitis suppurativa treatment with wide radical excision and skin grafting: a case report

Acne inversa, also referred to as purulent apocrine gland inflammation (hidradenitis suppurativa – HS), is a chronic inflammation of the skin, causing painful and purulent lesions that usually appear in the areas with a large number of apocrine glands, such as axillae, inguinal regions and inframammary folds. This study involves the case of a 46-year-old woman suffering from the treatment resistant Hurley Stage III HS. The patient underwent a series of surgeries using wide radical excision of the entire involved tissue, as well as graft procedures to treat extensive HS lesions in various body areas. Numerous treatment modalities regarding HS have been established, although their effects are not permanent enough to prevent recurrence. Therefore, surgery is regarded as the most effective, or even the only effective treatment of severe HS. Nevertheless, following the standard pharmacological and surgical treatment, it is crucial to ensure optimization of the nutritional parameters, reduction of friction and pressure in the affected area, appropriate wound care, weight loss and smoking cessation.