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To the Editor.—
I would like to agree wholeheartedly with early operative treatment. However, I do not think grafting is indicated except in rare circumstances. If one excises abscesses and cysts, as they appear, going deep into the fat and making certain that all apocrine gland tissue is removed, then grafting will be unnecessary. The wounds can either be left to heal by secondary intention or can be primarily sutured. With proper placement of incision, and with time, surprisingly little or no limitation of movement is encountered. This treatment is simpler than grafting, yields the same results, and does not result in the emotional trauma to the patient in having a recurrence beneath or at the edge of a graft, which we have seen all too often in patients who have had grafts.I would like to repeat, however, that definitive treatment should never consist of merely incision and drainage
Auerbach R. Treatment of Hidradenitis Suppurativa. JAMA. 1973;223(5):556-557. doi:10.1001/jama.1973.03220050056020