Comorbidities, treatment, and outcome in severe anogenital inverse acne (hidradenitis suppurativa): a 15-year single center report.

BACKGROUND: Acne inversa (hidradentitis suppurativa; AI) is a severe chronic relapsing inflammatory skin disease of unknown cause. Anogenital AI has the strongest negative impact on quality of life and causes great disability.

OBJECTIVES: We analyzed patients, comorbities, outcome of extensive surgery, and possible adverse effects.

PATIENTS AND METHODS: We included patients from January 2000 to March 2015 with anogenital AI Hurley grade III. They were further characterized by modified Sartorius scale, gender and age, comorbidities, pretreatments, and type of surgery (open or closed), and complications. Pain was measured by visual analogue scale (VAS). Treatment was performed by wide excision surgery.

RESULTS: A total of 117 patients were identified; mean age was 40.6 ± 12.6 years. The mean modified Sartorius score was 30.4 ± 8.4. Risk factors of obesity and active smoking were seen in 31.6% and 14.5%, respectively. Colostomy was needed in a single patient only. Pain was reduced significantly. Intra- and postoperative complications were seen in 20.5% (24/117).

CONCLUSIONS: Anogenital AI is a severe and potentially life threatening disease. Severe anogenital AI can be effectively treated by aggressive surgery. Outcome depends also on comorbidities.