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Ultrasound‐guided de‐roofing of epithelialised tunnels of hidradenitis suppurativa
Author(s) -
Der Sarkissian Sam,
Frew John W
Publication year - 2021
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/ajd.13600
Subject(s) - medicine , hidradenitis suppurativa , groin , axilla , surgery , skin grafting , occult , dermatology , disease , pathology , alternative medicine , cancer , breast cancer
Hidradenitis Suppurativa is a chronic inflammatory disease manifesting in painful nodules, abscesses and malodorous draining tunnels with a pre‐disposition to flexural regions of skin. Traditional surgical interventions include excision of clinically visible lesions and in severe cases – excision down to fascia of entire anatomical regions (axilla, groin) and repair with split‐thickness grafting or skin substitutes. However, such techniques are plagued by long healing times (up to several months), extensive tissue loss and high recurrence rates given that a large proportion of disease is not clinically visible. Deroofing is a tissue‐saving surgical technique, ideal for Hurley Stage 2 disease, which when combined with bedside pre‐operative sonography can allow for the accurate identification and removal of occult dermal tunnels whilst minimising the risks of pain, infection, minimising healing times and can be safely conducted in the setting of immunomodulatory therapy.