Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, often refractory to treatment. Patients with HS and dermatologists are in need of an effective, fast surgical intervention technique. Deroofing is a tissue-saving technique, whereby the "roof" of an abscess, cyst, or sinus tract is electrosurgically removed. The use of a probe is mandatory to explore the full extent of a lesion. Objective: We sought to evaluate the efficacy and patient satisfaction of the deroofing technique for recurrent Hurley I (mild) or II (moderate) graded HS lesions at fixed locations. Methods: An open study consisted of 88 deroofed lesions in 44 consecutive patients with HS, treated by a single clinician with a follow-up time of up to 5 years. Results: Fifteen of 88 (17%) treated lesions showed a recurrence after a median of 4.6 months. In all, 73 treated lesions (83%) did not show a recurrence after a median follow-up of 34 months. The median patient satisfaction with the procedure rated 8 on a scale from 0 to 10. Of the treated patients, 90% would recommend the deroofing technique to other patients with HS. One side effect occurred in the form of postoperative bleeding. Limitations: Some patients were lost to follow-up. Conclusions: The deroofing technique is an effective, simple, minimally invasive, tissue-saving surgical intervention for the treatment of mild to moderate HS lesions at fixed locations and it is suitable as an office procedure.

Additional Metadata
Keywords Acne inversa, Exteriorization, Hidradenitis suppurativa, Surgery, Treatment
Persistent URL dx.doi.org/10.1016/j.jaad.2009.12.018, hdl.handle.net/1765/20817
Citation
van der Zee, H.H, Prens, E.P, & Boer, J. (2010). Deroofing: A tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions. American Academy of Dermatology. Journal, 63(3), 475–480. doi:10.1016/j.jaad.2009.12.018