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
