Contemporary surgical treatment of hidradenitis suppurativa (HS) with a focus on the use of the diode hair laser in a case.
Hidradenitis suppurativa, a chronic recurrent disorder, characterized by painful, deep-seated nodules and abscesses commonly affecting the pilosebaceous-apocrine unit of the axillary, inguinal and mammary region in females, while the perianal area and buttocks are the prevalent sites in males. Its onset is after puberty, and may persist thereafter. Its exact aetiology is speculative. Follicular occlusion is the primary event leading to secondary inflammation, infection and destruction of the unit, ultimately affecting the adjoining subcutaneous tissue. Smoking and obesity may trigger or aggravate the condition. Stage of disease determines the mode of treatment. Medical treatment is valid in the early stage, but the results are transient. The early stage may warrant incision, and drainage of abscesses coupled with limited excision for locally recurring draining sinuses. While radical excision and healing with secondary intention, skin grafting, and flaps is recommended in advanced stages, laser therapy including the diode laser may prove a promising and innovative alternative.