Surgical Management of Pediatric Hidradenitis Suppurativa: A Case Series and Review of the Literature.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic and physically debilitating condition. Achieving long-term remission is difficult and sometimes remains elusive despite use of multiple pharmacological agents. However, surgery remains underused in the pediatric population. METHODS: We conducted a retrospective review for a 10-year period of all patients younger than 18 years who had undergone surgery for HS at a tertiary university hospital. In addition, we performed a literature review for English language articles related to the surgical management of pediatric HS patients. RESULTS: Eleven patients with a total of 23 operative sites were included in the study. The cohort was predominantly female (10:1) with an average age of 15.4 years and mean body mass index 31.9 kg/m. Lesion size ranged from 12.6 to 400 cm. Overall complication rate was 87% with a 7% reoperation rate to manage complications. Remission was achieved after a single procedure in 57% of sites. Three articles met our inclusion criteria for the literature review. CONCLUSIONS: Our article adds to the sparse literature and represents the largest study on surgical management of pediatric HS patients. Although surgery is not without its challenges, it presents a safe option and for pediatric HS patients with extensive scar or sinus tract formation.