CO2 laser deroofing technique: A robust and effective treatment for hidradenitis suppurativa regardless of comorbidities (a retrospective study of 334 lesions in 130 treated patients)

Abstract

Abstract Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects the terminal hair follicles in areas rich in apocrine glands. The condition most commonly manifests in the axillae, inframammary areas and genitofemoral region. Prevalence rates range between 1% and 4%. The management of HS encompasses both medical and surgical treatments, with surgical options including wide excision and carbon dioxide (CO2) laser‐assisted deroofing. Objectives The aim of this study is to characterize patients with HS and to evaluate the efficacy of CO2 laser‐assisted deroofing technique in the treatment of chronic HS lesions with a particular focus on recurrence rates. Methods This retrospective study included a cohort of 130 Danish patients treated at the Department of Dermatology, Aarhus University Hospital, Denmark, over a 4‐year period. All participants met the established criteria for HS and were treated using the deroofing technique. Data were manually extracted from the electronic patient record and subjected to statistical analysis using Microsoft Excel 2016 and STATA version 15. Kaplan−Meier survival curves were generated, and comparisons were made using the Log‐rank test. Results A total of 334 lesions were treated using the deroofing technique; 15.4% had Hurley stage I, 56.9% had Hurley stage II and 27.7% Hurley stage III. Recurrence was seen in 59 of 334 lesions (17.7%), affecting a total of 47 patients. Risk of recurrence was highest during the first 20 months. Conclusions This study confirms that CO2 laser deroofing is an effective treatment for chronic HS elements, demonstrating a low recurrence rate. Results showed that factors such as age, sex, diabetes, smoking habits, location of the treated area and lesion size did not significantly influence the risk of recurrence. However, patients with a body mass index greater than 25 showed a borderline significant increased risk of recurrence. The deroofing technique is robust and serves as an important tool in the surgeon's armamentarium.

Keywords

• carbon dioxide laser
• deroofing
• hidradenitis suppurativa
• treatment