Preview

Wounds and wound infections. The prof. B.M. Kostyuchenok journal

Advanced search

A one-stage radical surgical treatment of hidradenitis suppurativa of stage III by the Hurley classification of axillary location with wound plastic surgery using a posterior shoulder flap (a clinical case)

https://doi.org/10.25199/2408-9613-2024-11-2-36-43

Abstract

Hidradenitis suppurativa (acne inversa) is a chronic inflammatory skin disease that affects terminal hair follicles in the area of apocrine sweat glands. The disease is manifested by the formation of recurrent inflammatory nodes with purulent discharge, prone to the formation of fistulas and scars. The axillary region is one of the common affected areas.

The article presented a clinical case of radical surgical management of hidradenitis suppurativa of stage III by the Hurley classification. The described surgical treatment included extensive resection of pathologically changed soft tissues of the axillary region with simultaneous wound repair using a displaced fascio-cutaneous flap taken from the posterior surface of the shoulder.

About the Authors

A. V. Kuznetsov
City Clinical Hospital No. 13
Russian Federation

Anton V. Kuznetsov – MD, surgeon, orthopedist-traumatologist at the  department of purulent surgery

1/1 Velozavodskaya Str., Moscow, 115280



A. A. Plotnikov
City Clinical Hospital No. 13
Russian Federation

Alexey A. Plotnikov – MD, surgeon at the department of purulent surgery

1/1 Velozavodskaya Str., Moscow, 115280



V. N. Obolenskiy
City Clinical Hospital No. 13; N.I. Pirogov Russian National Research Medical University
Russian Federation

Vladimir N. Obolenskiy – MD, Cand. Sc. (Med.), surgeon,  orthopedisttraumatologist, head of the Center for Purulent Surgery; Associate Professor at the department of general surgery, Faculty of Medicine

1/1 Velozavodskaya Str., Moscow, 115280;

1 Ostrovityanova Str., Moscow, 117513



A. S. Pirogova
Russian Medical Academy of Continuous Professional Education; I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Anna S. Pirogova – MD, postgraduate student at the department of skin and venereal diseases; assistant at the department of dermatology and  cosmetology

2/1 Barrikadnaya Str., Moscow, 125993;

8/2 Trubetskaya Str., Moscow 119048



N. P. Teplyuk
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Natalia P. Teplyuk – MD, Dr. Sci. (Med.), Professor at the department of skin and venereal diseases

8/2 Trubetskaya Str., Moscow 119048



P. Sh. Leval
City Clinical Hospital No. 13
Russian Federation

Pulad Sh. Leval – MD, surgeon, orthopedist-traumatologist, head of the  department of purulent surgery

1/1 Velozavodskaya Str., Moscow, 115280



O. V. Grabovskaya
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Olga V. Grabovskaya – MD, Cand. Sc. (Med.), Professor at the department of skin and venereal diseases

8/2 Trubetskaya Str., Moscow 119048



A. A. Konnov
City Clinical Hospital No. 13
Russian Federation

Andrey A. Konnov – MD, orthopedist-traumatologist at the department of purulent surgery

1/1 Velozavodskaya Str., Moscow, 115280



A. T. Urmancheeva
City Clinical Hospital No. 13
Russian Federation

Alina T. Urmancheeva – MD, orthopedist-traumatologist at the department of purulent surgery

1/1 Velozavodskaya Str., Moscow, 115280



M. A. Kuligina
City Clinical Hospital No. 13
Russian Federation

Margarita A. Kuligina – MD, surgeon at the department of purulent surgery

1/1 Velozavodskaya Str., Moscow, 115280



G. A. Grigoryan
City Clinical Hospital No. 13; Patrice Lumumba Peoples’ Friendship University of Russia
Russian Federation

Grair A. Grigoryan – MD, orthopedist-traumatologist at the department of traumatology; postgraduate student at the department of traumatology and orthopedics

1/1 Velozavodskaya Str., Moscow, 115280;

8 Miklukho-Maklaya Str., Moscow, 117198



References

1. Sirvan S. S., Demir I. A., Irmak F., et al. Posterior Arm Perforator Flap for Axillary Reconstruction After Hidradenitis Suppurativa Excision. Plast Surg (Oakv). 2019; 27 (3): 204–210.

2. Teplyuk N. P., Pirogova A. S. Inverse acne: a clinical observation = Teplyuk N. P., Pirogova A. S. Inversnyye akne: klinicheskoye nablyudeniye Rossiyskiy zhurnal kozhnykh i venericheskikh bolezney. 2021; 24 (1): 71–76. (In Russ.)

3. Seivright J., Collier E., Grogan T., et al. Pediatric hidradenitis suppurativa: epidemiology, disease presentation, and treatments. J Dermatolog Treat. 2022; 33 (4): 2391–2393.

4. Schrader A. M., Deckers I. E., van der Zee H. H., et al. Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol. 2014; 71 (3): 460– 467.

5. Wang B., Yang W., Wen W., et al. Gamma-secretase gene mutations in familial acne inversa. Science. 2010; 330 (6007): 1065.

6. van der Zee H. H., de Winter K., van der Woude C. J., Prens E. P. The prevalence of hidradenitis suppurativa in 1093 patients with inflammatory bowel disease. Br J Dermatol. 2014; 171 (3): 673–675.

7. Barlev D., Eisen D. B., Alikhan A. Hidradenitis suppurativa: a review with a focus on treatment data. Skin Therapy Lett. 2015; 20 (4): 1–8.

8. Revuz J. E., Canoui-Poitrine F., Wolkenstein P., et al. Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol. 2008; 59 (4): 596–601.

9. Scheinfeld N. Diseases associated with hidranitis suppurativa: part 2 of a series on hidradenitis. Dermatol Online J. 2013; 19 (6): 18558.

10. Leybishkis B., Fasseas P., Ryan K. F., Roy R. Hidradenitis suppurativa and acne conglobata associated with spondyloarthropathy. Am J Med Sci. 2001; 321 (3): 195–197.

11. von Laffert M., Stadie V., Wohlrab J., Marsch W. C. Hidradenitis suppurativa/acne inversa: bilocated epithelial hyperplasia with very different sequelae. Br J Dermatol. 2011; 164 (2): 367–371.

12. van der Zee H. H., Laman J. D., Boer J., Prens E. P. Hidradenitis suppurativa: viewpoint on clinical phenotyping, pathogenesis and novel treatments. Exp Dermatol. 2012; 21 (10): 735–739.

13. Nikolakis G., Liakou A. I., Bonovas S., et al. Bacterial Colonization in Hidradenitis Suppurativa/Acne Inversa: A Cross-sectional Study of 50 Patients and Review of the Literature. Acta Derm Venereol. 2017; 97 (4): 493– 498.

14. Brook I., Frazier E.H. Aerobic and anaerobic microbiology of axillary hidradenitis suppurativa. J Med Microbiol. 1999; 48 (1): 103–105.

15. Hurley H. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus: surgical approach. In: Dermatologic surgery. New York: Marcel Dekker; 1989: pp. 729–739.

16. Goldburg S. R., Strober B. E., Payette M. J. Hidradenitis suppurativa: Epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol. 2020; 82 (5): 1045–1058.

17. Canoui-Poitrine F., Revuz J. E., Wolkenstein P., et al. Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. J Am Acad Dermatol. 2009; 61 (1): 51–57.

18. Mohammadi S., Gholami A., Hejrati L., et al. Hidradenitis suppurativa; classification, remedies, etiology, and comorbidities; a narrative review. J Family Med Prim Care. 2021; 10 (11): 4009–4016.

19. Zouboulis C. C., Desai N., Emtestam L., et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015; 29 (4): 619–644.

20. Shukla R., Karagaiah P., Patil A., et al. Surgical Treatment in Hidradenitis Suppurativa. J Clin Med. 2022; 11 (9): 2311.

21. Masyukova S. A., Mordovtseva V. V., Zemlyakova S. S., et al. Suppurative hidradenitis: treatment (part 3) = Masyukova S. A., Mordovtseva V. V., Zemlyakova S. S. i dr. Gnoynyy gidradenit: lecheniye (chast’ 3). Rossiyskiy zhurnal kozhnykh i venericheskikh bolezney. 2016; 19 (4): 233–237. (In Russ.)

22. Ortiz C. L., Castillo V. L., Pilarte F. S., Barraguer E. L. Experience using the thoracodorsal artery perforator flap in axillary hidradentitis suppurativa cases. Aesthetic Plast Surg. 2010; 34 (6): 785–792.

23. Soldin M. G., Tulley P., Kaplan H., et al. Chronic axillary hidradenitis--the efficacy of wide excision and flap coverage. Br J Plast Surg. 2000; 53 (5): 434–436.

24. Thomson D. R., Saltrese S., Mehdi S. Modified Posterior Arm Flap for Axillary Hidradenitis Suppurativa. Ann Plast Surg. 2022; 88 (1): 84–87.

25. Zouboulis C. C., Bechara F. G., Dickinson-Blok J. L., et al. Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization - systematic review and recommendations from the HS ALLIANCE working group. J Eur Acad Dermatol Venereol. 2019; 33 (1): 19–31.

26. Masquelet A. C., Rinaldi S. Anatomical basis of the posterior brachial skin flap. Anat Clin. 1985; 7 (3): 155–160.

27. Ching D. L., Mughal M., Papas A., Soldin M. Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect. Arch Plast Surg. 2017; 44 (3): 228–233.

28. Bezoyan V. S., Dorozhko Yu. A., Braker E. A. Elimination of post-burn adductor contracture of the shoulder of the third degree with modification of the defect by a posterior cutaneous-fascial shoulder flap on a wide base = Bezoyan V. S., Dorozhko Yu. A., Braker Ye. A. Ustraneniye posleozhogovoy privodyashchey kontraktury plecha III stepeni s izmeneniyem defekta zadnim kozhno-fastsial’nym loskutom plecha na shirokom osnovanii. Kombustiologiya. 2017; 58. (In Russ.)

29. Schmidt M., Dunst-Huemer K. M., Lazzeri D., et al. The versatility of the islanded posterior arm flap for regional reconstruction around the axilla. J Plast Reconstr Aesthet Surg. 2015; 68 (7): 953–959.

30. M KP, Ete G, J FCM, Akamanchi AK, Agarwal S. Simultaneous Bilateral Reconstruction of the Axilla with Posterior Arm Flap in Recurrent Hidradenitis Suppurativa. Indian J Plast Surg. 2022; 55 (1): 66–69.


Review

For citations:


Kuznetsov A.V., Plotnikov A.A., Obolenskiy V.N., Pirogova A.S., Teplyuk N.P., Leval P.Sh., Grabovskaya O.V., Konnov A.A., Urmancheeva A.T., Kuligina M.A., Grigoryan G.A. A one-stage radical surgical treatment of hidradenitis suppurativa of stage III by the Hurley classification of axillary location with wound plastic surgery using a posterior shoulder flap (a clinical case). Wounds and wound infections. The prof. B.M. Kostyuchenok journal. 2024;11(2):36-43. (In Russ.) https://doi.org/10.25199/2408-9613-2024-11-2-36-43

Views: 458


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2408-9613 (Print)
ISSN 2500-0594 (Online)
X