Hidradenitis suppurativa: successful treatment using carbon dioxide laser excision and marsupialization.

BACKGROUND Hidradenitis suppurativa (HS) is a disease associated with significant patient morbidity and less-than-ideal therapies. OBJECTIVES To determine the long- and short-term benefits of carbon dioxide (CO(2)) laser excision and marsupialization in the management of persisent lesions of HS. METHODS Patients with long-standing lesions of HS were treated using a CO(2) laser to excise inflammatory and draining masses. RESULTS One hundred eighty-five areas were treated in 61 patients using the CO(2) laser excision and marsupialization technique in 154 sessions. Local anesthesia was used for all but three sessions. Healing occurred primarily through secondary intention. In follow-up from 1 to 19 years, acceptable to excellent qualities of healing occurred. Recurrence within the treated area occurred in two of 185 sites treated. CONCLUSION CO(2) laser excision and marsupialization appears to be an effective therapy for management of persisent or late-stage HS. There was good patient comfort during and after treatment, lower costs than with inpatient modalities, good healing, and minimal risk of recurrence within the treated areas.