Recurrence after surgical treatment of hidradenitis suppurativa

From six to 89 months after surgery 82 patients who had been treated by radical surgery (118 excisions) for intractable hidra- denitis suppurativa were reviewed.Local recurrence rates varied greatly with the disease site, being low after axillary (3%) and perianal surgery (0%) and high after inguinoperineal (37%) and submammary (50%) excision.Recurrence results from inadequate excision or an unusually wide distribution ofapocrine glands, but physical factors such as obesity, local pressure, and skin maceration played a part in a few patients.Recurrence due to inadequate surgery tended to be the most troublesome.At follow up 75 (91%) ofthe patients were pleased with the results of their operation.A quarter of the patients developed disease at a new anatomical site after operation.Radical surgery gives good symptomatic control of severe hidradenitis suppurative of the axilla, inguinoperineal, and perianal regions but is less satisfactory for submammary disease.