title: Comorbidities, treatment, and outcome in severe anogenital inverse acne (hidradenitis suppurativa): a 15-year single center report.
abstract: 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.
  
  
  OBJECTIVE
  We analyzed patients, comorbities, outcome of extensive surgery, and possible adverse effects.
  
  
  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.
authors: Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors: Uwe
authors: U
authors: Wollina
authors: Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors: Dana
authors: D
authors: Langner
authors: Center of Physical Therapy and Rehabilitative Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors: Birgit
authors: B
authors: Heinig
authors: Department of Anesthesiology and Intensive Care Medicine, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors: Andreas
authors: A
authors: Nowak
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000209:etiology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology / Q000601:surgery*; D005832:Genital Diseases, Male / Q000209:etiology / Q000601:surgery*; D017497:Hidradenitis Suppurativa / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011183:Postoperative Complications; D012008:Recurrence; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D013997:Time Factors; D014945:Wound Healing; D055815:Young Adult