Histopathologic study of hidradenitis suppurativa following long-pulsed 1064-nm Nd:YAG laser treatment.
OBJECTIVE
To assess clinical and histopathologic changes occurring after long-pulsed 1064-nm Nd:YAG laser treatment of hidradenitis suppurativa (HS).


METHODS
Prospective, controlled clinical and histologic study of patients with Hurley stage II HS disease.


METHODS
Outpatient dermatology department at Henry Ford Hospital, Detroit, Michigan.


METHODS
Nineteen patients with Fitzpatrick skin types II to VI with Hurley stage II HS lesions of the axilla and groin. Interventions Two monthly laser sessions were performed using the long-pulsed 1064-nm Nd:YAG laser. Main Outcome Measure Clinical response was scored using the modified Sartorius scale for HS reflecting Lesion Area and Severity Index (LASI). Histologic changes were examined before treatment and 1 week, 1 month, and 2 months after treatment.


RESULTS
The percentage change in HS severity after 2 sessions of laser treatment was -31.6 over all anatomic sites (P < .005), -24.4 for the axillary site (P = .008), and -36.8 for the inguinal site (P = .001). Histologic changes corresponded to clinical response. Findings from serial biopsy specimens showed increased inflammation at 1 week after treatment and decreased inflammation with resulting fibrosis and scarring at 1 month and 2 months after treatment.


CONCLUSIONS
The long-pulsed 1064-nm Nd:YAG laser is a novel effective treatment option for HS. Our histopathologic data suggest that HS is primarily a follicular disorder. The Nd:YAG laser penetrates for selective photothermolysis of the follicular unit and destruction of organized inflammatory lesions in the superficial to mid dermis. Our study offers insight into the pathogenesis of HS and the mechanism of the Nd:YAG laser in treatment of patients with this chronic, debilitating disease.
Xu
Lisa Y
LY
Department of Dermatology, Henry Ford Hospital, Detroit, MI 48202, USA.
Wright
Dakara Rucker
DR
Mahmoud
Bassel H
BH
Ozog
David M
DM
Mehregan
David A
DA
Hamzavi
Iltefat H
IH
D000328:Adult; D001365:Axilla; D001706:Biopsy; D002921:Cicatrix / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000209:etiology / Q000473:pathology; D005500:Follow-Up Studies; D006119:Groin; D017497:Hidradenitis Suppurativa / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult