Improvement of Therapy Outcomes after Negative Pressure Wound Therapy in a Patient with Acne inversa.
Abstract
Treatment of acne inversa (also known as hidradenitis suppurativa) is complicated and chronic. This debilitating, inflammatory disease of the follicular sacks affects mostly young adults and has a strong negative impact on their quality of life. We present a case of a 28 year old woman with a history of acne
inversa of Hurley grade 2 for 6 years. Patient underwent surgical excision of the skin of the left inguinum followed by negative pressure therapy dressings for 2 and a half weeks (5 dressing changes). This allowed a full closure of the wound after 12 weeks and formation of a well accepted scar. Patient’s pain
decreased from 4.5 to 1.5 according to visual assessment scale. We also noted a 28 point decrease in disease severity score according to Sartorius scale and a 19 point decrease in Dermatology Life Quality Index. Two years prior admission patient had undergone surgical treatment of her right inguinum with split thickness skin grafting, which healed for 26 weeks and yielded less satisfactory results. Comparison photographs of both treatment results are presented.
References
G. B. Jemec, M. Heidenheim, and N. H. Nielsen, “The prevalence of hidradenitis suppurativa and its potential precursor lesions,” Journal of the American Academy of Dermatology, vol. 35, no. 2, pp. 191–194, 1996.
C. YU and M. Cook, “Hidradenitis suppurativa: a disease of follicular epithelium, rather than apocrine glands,” British Journal of Dermatology, vol. 122, no. 6, pp. 763–769, 1990.
R. Attanoos, M. Appleton, and A. Douglas-Jones, “The pathogenesis of hidradenitis suppurativa: a closer look at apocrine and apoeccrine glands,” British Journal of Dermatology, vol. 133, no. 2, pp. 254–258, 1995.
J. Boer and E. Weltevreden, “Hidradenitis suppurativa or acne inversa. a clinicopathological study of early lesions,” British Journal of Dermatology, vol. 135, no. 5, pp. 721–725, 1996.
T. Jansen, P. Altmeyer, and G. Plewig, “Acne inversa (alias hidradenitis suppurativa),” Journal of the European Academy of Dermatology and Venereology, vol. 15, no. 6, pp. 532–540, 2001.
H. Hurley, “Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus: surgical approach,” Dermatologic surgery. New York: Marcel Dekker, pp. 729–39, 1989.
K. Sartorius, J. Lapins, L. Emtestam, and G. Jemec, “Suggestions for uniform outcome variables when reporting treatment effects in hidradenitis suppurativa,” British journal of dermatology, vol. 149, no. 1, pp. 211–213, 2003
Revuz, J, "Hidradenitis suppurativa," Journal of the European Academy of Dermatology and Venereology, vol. 23, no. 9, pp. 985--998, 2009
S. Ather, D. S. Chan, D. J. Leaper, and K. G. Harding, “Surgical treatment of hidradenitis suppurativa: case series and review of the literature,” International wound journal, vol. 3, no. 3, pp. 159–169, 2006
E. Chen and H. I. Friedman, “Management of regional hidradenitis suppurativa with vacuum-assisted closure and split thickness skin grafts,” Annals of plastic surgery, vol. 67, no. 4, pp. 397–401, 2011.
E. T. Elwood and D. G. Bolitho, “Negative-pressure dressings in the treatment of hidradenitis suppurativa,” Annals of plastic surgery, vol. 46, no. 1, pp. 49–51, 2001.
P. J. Hynes, M. Earley, and D. Lawlor, “Split-thickness skin grafts and negative-pressure dressings in the treatment of axillary hidradenitis suppurativa,” British Journal of Plastic Surgery, vol. 55, pp. 507–509, Sep 2002.
A. Finlay and G. Khan, “Dermatology life quality index (dlqi)—a simple practical measure for routine clinical use,” Clinical and experimental dermatology, vol. 19, no. 3, pp. 210–216, 1994.
T. Banasiewicz and M. Drews, “Negative pressure wound therapy (npwt) in open abdomen – an animal model for surgeons training,” Negative Pressure Wound Therapy, vol. 1, pp. 48–53, Apr 2014.
S. Singh, “Role of negative pressure wound therapy in plastic surgery - its basics, indications and contraindications,” Negative Pressure Wound Therapy, vol. 1, pp. 67–68, Apr 2014.
T. Banasiewicz, A. Bobkiewicz, M. Borejsza-Wysocki, M. Biczysko, A. Ratajczak, S. Malinger, and M. Drews, “Portable vac therapy improve the results of the treatment of the pilonidal sinus– randomized prospective study,” Pol Przegl Chir, vol. 85, pp. 371–3768, Jul 2013.
Nikodem Horst and Tomasz Banasiewicz and Piotr Krokowicz, "Complex Posttraumatic Perineal Wound with Rectovaginal Fistula - Treatment with Negative Pressure Therapy," Negative Pressure Wound Therapy, vol. 1, no. 1, pp. 17--21, 2014
Copyright (c) 2014 Wojciech Francuzik, Tomasz Banasiewicz, Zygmunt Adamski
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
We require authors to sign a Publication Agreement prior to publication of the manuscript in NPWTJ. The link to this form may be found below.
PUBLICATION AGREEMENT FORM
