Surgical deroofing safely manages hidradenitis suppurativa

BOSTON — Surgical deroofing is a safe and effective technique for the management of hidradenitis suppurativa, according to a study presented at the American Academy of Dermatology Annual Meeting.

According to Trang T. Vu, MD, PhD, of the University of Alberta, and colleagues, deroofing is a surgical technique in which the dermis or “roof” of a lesion is excised and the underlying wound is curetted and then allowed to heal by secondary intention.

This technique can be used for both acute and chronic lesions and can be performed in outpatient settings.

The researchers noted that current guidelines advocate for both medical and surgical management of HS. However, because patients often continue to experience flares despite medical therapy, surgical modalities serve as a much-needed intervention for many patients.

To evaluate the safety and efficacy of the technique, Vu and colleagues performed a single-arm, prospective study that included 43 patients with Hurley stage I to III HS. In total, they deroofed 123 lesions.

After 3 months, 7% of the deroofed sites had one recurrence, 41% reported no erythema and 93% reported no discharge at the surgical site.

Patient-reported pain based on an 11-point numerical scale with 10 being the worst pain was reduced from an average of 8 at baseline to 1. Dermatology Life Quality Index was also reduced from 15 (range, 0-30) at baseline to 8 (range, 0-25).

Additional patient reports showed that 91% would undergo another deroofing procedure and 95% were satisfied to very satisfied with the procedure. Five percent of patients reported postoperative infection and 19% reported postoperative pain.