ABSTRACT
Hidradenitis suppurativa (HS) is a chronic debilitating disorder that can affect any
areas bearing apocrine glands. Perineal HS is associated with high morbidity compared
with other anatomic regions. Early-stage disease may mimic various other forms of
cutaneous disorders, but as HS progresses pathognomonic skin changes occur. Clinical
stage can guide the therapeutic approach, but the lowest recurrence rate is obtained
by removing all involved skin and subcutaneous fat. Pruritus ani is a complex disease
with a multitude of etiologies. Its management can be frustrating and disappointing
for the patient and doctor alike. The key is to start with simple treatment options
focusing on perianal hygiene and avoidance of the most common offending foods and
beverages. If these measures fail, topical medications should be attempted before
graduating to perianal injections of methylene blue as a last resort.
KEYWORDS
Hidradenitis suppurativa - acne inversa - pruritus ani
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Martin A LuchtefeldM.D.
Division of Colon and Rectal Surgery, Spectrum Health
4100 Lake Dr. SE, Ste 205, Grand Rapids, MI 49546
Email: Mluchtefeld@gmail.com
