Hiradenitis Suppuritiva

About Hiradenitis Suppuritiva

What is Hidradenitis Suppurativa?

HS is a chronic skin condition where painful lumps, boils, and abscesses form in areas like:
• Armpits
• Groin
• Under the breasts
• Buttocks
These lumps can rupture, leak pus, and leave deep scars or tunnels (sinus tracts)
over time.
It’s not contagious, but it can be physically and emotionally draining.

Why does it happen?

It’s caused by blocked hair follicles and inflammation, often triggered or worsened by:

  • Hormonal changes
  • Obesity
  • Smoking
  • Genetics

Treatment Options for Hidradenitis Suppurativa

Treatment depends on the severity (mild, moderate, or severe). Early care can prevent longterm damage.

1. Lifestyle Modifications & Skin Care

Helps reduce flare-ups and severity

2. Medical Management

Topical Treatments (for mild HS)

Short-term use to control early lumps

Oral Antibiotics

Reduce inflammation and prevent infection

Biologic Injections

Best for moderate to severe HS or when other treatments fail

3. Surgical Options

For persistent or advanced HS, surgery can provide long-term relief:
Surgery involves excision and reconstruction options depend on the extent of excision.

Secondary Intention Healing

Wound is left open to heal naturally over time

Requires regular dressings

Useful for small, superficial wounds

Slower recovery, may leave contracture or scars

Split-Thickness Skin Graft (STSG)

A thin layer of skin is taken from the thigh and placed over the wound

Covers large areas effectively

Heals faster than secondary intention

Skin may look and feel different from surrounding area

Local Flaps

Skin and tissue from adjacent areas are rotated or moved to cover the defect

Maintains color, texture, and thickness match

Provides better mobility and cosmetic result

Commonly used in underarm and groin HS excisions

Regional or Perforator Flaps

Tissue from a nearby region (with its blood supply) is tunneled or moved

Examples: Limberg flap, gracilis flap, or gluteal/perforator flaps

Best for larger or deeper wounds

Provides robust, long-lasting coverage

Free Flap Reconstruction (for extensive disease)

Tissue (skin, fat, muscle) is taken from a distant part of the body and reconnected using microsurgery

Rare, but used when local options are unavailable due to recurrent surgeries or scarring

Example: Radial forearm flap or Free Antero Lateral thigh flap

Final Thoughts:

Reconstruction in HS is not just about closing the wound — it’s about:

  • Reducing recurrence
  • Improving quality of life
  • Restoring function (e.g., arm movement, sitting comfort)
  • Minimizing scarring and contractures
Each case is different, and the best reconstruction plan depends on:
  • Size and location of the defect
  • Prior surgeries
  • Overall health and skin condition
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