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January 29, 1973

Treatment of Hidradenitis Suppurativa

Author Affiliations

East Lansing, Mich

JAMA. 1973;223(5):557. doi:10.1001/jama.1973.03220050056021

To the Editor.—  We are in agreement with the recommendation of Shaughnessy et al (222:320, 1972) that the proper treatment of hidradenitis suppurativa, in its chronic stage, is the total excision of the apocrine-glandbearing tissue. In our experience, however, their method of reconstructing the axillary or groin defect by means of a partial thickness skin graft is one that we believe should be avoided.As indicated by the authors, partial thickness skin grafts contract, and in many instances this results in significant restriction of joint movement. To overcome this shortcoming, "airplane" splints to hold the patient's arm in abduction while the graft matures over several months have been advocated. In addition to the discomfort and inconvenience to the patient, we have seen a transient brachial plexus palsy result from the use of these splints.Moreover, in the clinical setting of a chronic infection, as seen in hidradenitis suppurativa, a portion