Skin-tissue-sparing excision with electrosurgical peeling: A case series in hidradenitis suppurativa

Abstract

Hidradenitis suppurativa (HS) is a chronic, debilitating, inflammatory skin condition that affects 1% of the general population (1). The disease predominantly affects inverse areas of the body like the axillae and the groins, and presents with painful, inflammatory nodules, abscesses, sinus tracts, pseudocomedones and scarring (1). HS is difficult to treat. In severe HS, sinus tracts, fibrotic tissue and architectural loss will remain after pharmacological therapy. Surgery is the only approach able to remove these lesions (1, 2). In Hurley stage I/II the de-roofing technique is widely used (3). Wide excision is often performed in Hurley stage II/III as it reaches deeper structures (4). We have previously described a new surgical technique for Hurley stage II/III: the Skin-Tissue-sparing Excision with Electrosurgical Peeling (STEEP) procedure. Briefly, during STEEP all affected tissue is removed by subsequent tangential transections, whilst saving as much healthy tissue as possible. In theory, this leads to rapid healing, satisfying cosmetic results and prevention of contractures (5, 6). This prospective study aimed to investigate the shortand mid-term outcomes of the STEEP procedure.