Aggravation of mild axillary hidradenitis suppurativa by microwave ablation

To the Editor:
Hidradenitis suppurativa (HS) is a common chronic, recurrent, autoinflammatory skin disease of the hair follicle with limited treatment options. No definitive treatment exists for this debilitating entity. MiraDry (Miramar Labs Incorporated, Santa Clara, CA) is a microwave device targeting the eccrine and apocrine sweat glands as well as hair follicles through thermolysis in the dermal-hypodermal junction. We hypothesized that this noninvasive ablative technique could potentially improve the clinical symptoms of HS by reducing the number of hair follicles (primary action) and the destruction of the inflammatory cell infiltrate (secondary action) in HS lesions. We, therefore, evaluated the efficacy and safety of miraDry treatment for mild axillary HS in a randomized intrapatientecontrolled trial (ethical approval by the IRB of the Erasmus University Medical Center; MEC-2017-390). [...]