Wide Local Excision as a Frontline Treatment for Hidradenitis Suppurativa

Wide local excision (WLE) of Hidradenitis Suppurativa (HS) lesions could be considered as a frontline treatment, according to a recent study published in Dermatologic Surgery.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects patients' quality of life (QoL). The skin lesions develop as a result of inflammation and infection of sweat glands. This condition features pea- to marble-sized lumps under the skin that can be painful and tend to enlarge and drain pus.

A group of researchers from Germany conducted a study to investigate changes in quality of life (QoL) in patients with Hidradenitis suppurativa (HS) after wide local excision (WLE) and to examine the level of pain, rate of postoperative complications, recurrences, and the time to complete wound closure.

Fifty-five patients were enrolled in this prospective study. All patients underwent wide local excision (WLE) of Hidradenitis suppurativa (HS), followed by secondary wound healing. Dermatologic Life Quality Questionnaire, pain and wound size were measured 1 day, 3 weeks, 3 months, and 6 months after surgery.

Study Results

• Dermatologic Life Quality Questionnaire and pain scores improved significantly from 14.5 ± 7.3 and 3.7 ± 2.8 at baseline to 5.8 ± 6.9 and 0.8 ± 1.7, 6 months postoperatively, respectively.
• Wounds were closed completely by secondary intention after 4.4 ± 2.8 months.
• Sixteen patients (29.1%) experienced postoperative complications.
• Local recurrences in the treated sites were observed in 11 patients (20%).
• New lesions in untreated sites were observed in 5 cases (9.1%).

Thus, the researchers concluded that Wide local excision (WLE) significantly improves patients' quality of life (QoL) and pain, and, given its low rate of recurrence and complications, should be considered as first-line therapy, especially in patients with higher Hurley stages.

Reference

Improvement in Quality of Life and Pain in Patients With Hidradenitis Suppurativa After Wide Local Excision: A Prospective Study by Dick, Julika et al. published in Dermatologic Surgery.

DOI: 10.1097/DSS.0000000000003235