Surgical Deroofing in the Management of Hidradenitis Suppurativa Alone or as an Adjunct to Medical Therapies

Abstract

Background: Hidradenitis suppurativa (HS) is an inflammatory condition that remains challenging to manage. Deroofing is a surgical technique whereby the "dermal roof" of the entire lesion and sinus tracts are removed.

Objective: A prospective study was conducted to assess the efficacy and safety of deroofing in the management of both acute and chronic HS lesions in Hurley Stage I-III disease. The role of deroofing as an adjunct to adalimumab and the impact of deroofing on pain control and quality of life (QoL) were also quantified.

Methods: Forty-four patients were enrolled in an open, single arm study treated by a single clinician. In total, 115 lesions were deroofed and patients were followed at 3 and 12 months after deroofing.

Results: At 3 and 12 months, the recurrence rate was 10% (12/115) and 11% (13/108), respectively. Deroofing is an effective adjunctive treatment for patients on adalimumab. Deroofing also improved pain and QoL scores.

Conclusion: Deroofing is a safe and effective surgical technique that can be used for acute and chronic recurrent/fixed lesions in Hurley I-III disease alone or as an adjunct to systemic therapies. Deroofing has a low recurrence rate, reduces pain, and improves QoL.