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Journal of the American Academy of Dermatology
Volume 63, n° 3
pages 475-480 (septembre 2010)
Doi : 10.1016/j.jaad.2009.12.018
accepted : 9 December 2009
Dermatologic Surgery

Deroofing: A tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions
 

Hessel H. van der Zee, MD a, , Errol P. Prens, MD, PhD a, Jurr Boer, MD, PhD b
a Departments of Dermatology and Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands 
b Department of Dermatology, Deventer Hospital, Deventer, The Netherlands 

Reprint requests: Hessel H. van der Zee, MD, Departments of Dermatology and Immunology, Erasmus MC, University Medical Center, Room Ee867e, Dr Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.
Abstract
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.

The full text of this article is available in PDF format.

Key words : acne inversa, exteriorization, hidradenitis suppurativa, surgery, treatment



 Funding sources: None.
 Conflicts of interest: None declared.



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