title: New and traditional surgical approaches to hidradenitis suppurativa.
abstract: When the prevention of new lesions fails and when medical therapy of established and growing lesions is ineffective, surgery is the accepted method of dealing with hidradenitis suppurativa/acne inversa. The rationale and preferred techniques of mini-unroofing using a biopsy punch, deroofing using scissors, electrosurgery or laser, and classical wide excision and closure are discussed. The situation in which incision and drainage is considered for temporary pain relief would be best considered an opportunity for deroofing, as illustrated in the accompanying online videos.
authors.affiliation: Geisel School of Medicine, Dartmouth University, Manchester, New Hampshire. Electronic address: billdanbymd@gmail.com.
authors.forename: F William
authors.initials: FW
authors.lastname: Danby
authors.affiliation: Hidradenitis Suppurativa Institute, Westlake, Ohio.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Hazen
authors.affiliation: Department of Dermatology, Deventer Hospital, Deventer, The Netherlands.
authors.forename: Jurr
authors.initials: J
authors.lastname: Boer
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D003452:Cryosurgery / Q000379:methods* / Q000639:trends; D004322:Drainage / Q000379:methods; D004598:Electrosurgery / Q000379:methods* / Q000639:trends; D005260:Female; D005544:Forecasting; D017497:Hidradenitis Suppurativa / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011379:Prognosis; D018570:Risk Assessment; D055502:Secondary Prevention / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
keywords: biopsy; cryoinfusion; cryosurgery; deroofing; electrosurgery; excision; hidradenitis suppurativa; incision and drainage; photodynamic therapy; prevention; surgery; unroofing