Treatment of hidradenitis suppurativa with carbon dioxide laser excision and second-intention healing

Background: Hidradenitis suppurativa is a disabling disease. Although medical management can at times control the disease, the treatment of choice is surgical excision. Surgical defects have been managed by second-intention healing, simple surgical closure, or complex surgical repairs. Objective: Our purpose was to determine the benefit of carbon dioxide laser excision with healing by second intention to treat lesions of hidradenitis suppurativa. Methods: We treated seven patients who had axillary and inguinoperineal hidradenitis suppurativa with carbon dioxide laser excision followed by second-intention healing. A total of 12 procedures were performed (five bilateral and two unilateral). Follow-up periods were 10 to 27 months. Results: After a healing time of 4 to 8 weeks, scars were flat and linear. Only one recurrence of hidradenitis suppurativa has been observed; this occurred along the margin of the surgical scar in a previously treated area, Some patients, however, had continued disease activity in untreated areas. All subjects were satisfied with the results of the procedure, and complications were minimal. Conclusion: Carbon dioxide laser excision with second-intention healing is safe and effective for hidradenitis suppurativa.