Carbon dioxide laser excision in hidradenitis suppurativa: Demographics, comorbidities, healing time and complications.
Lasers Surg Med
Background: Hidradenitis suppurativa (HS) is often refractory to standard medical and surgical interventions. Objectives: We characterized the efficacy and safety of carbon dioxide (CO2) laser excision for the treatment of recalcitrant hidradenitis suppurativa (HS) in an urban, academic dermatology center. Methods: On initial data pull, 72 patients were identified. This number was reduced to 38 patients by including HS patients with all data points at Henry Ford Hospital who underwent CO2 laser excision between August 2014 to May 2017. Data were obtained from medical charts including healing and recurrence rates, complications, smoking status, and history of diabetes mellitus. Results: The average age at the time of the procedure was 37.5 years and mean BMI was 34.9. In total, 3 patients had recurrence at a mean of 6 months following the procedure. Post-operative complications included: infection (n=2), contracture (n=2), dehiscence (n=2), paresthesias (n=1). Patients with dehiscence were not smokers or diabetics. A total of 12 patients reported current cigarette use, 5 patients were former smokers, and 21 patients had never smoked. The mean healing time in both smokers and nonsmokers was 6 months. Nine patients had a history of diabetes mellitus, and 29 patients were not diabetic. The mean healing time was not significantly prolonged in diabetics when compared to non-diabetics and was 7.3 months and 5.4 months respectively. Conclusion: Both smokers and non-smokers demonstrated similar wound healing time, recurrence rates, and post-operative complications. Patients with diabetes mellitus had a prolonged healing time when compared to those without diabetes mellitus. Our study identifies important characteristics that clinicians should consider when assessing HS patients for CO2 laser excision. Learning Objectives: 1. CO2 laser excision is a safe and effective treatment for hidradenitis suppurativa 2. Smokers and non-smokers have similar wound healing time, recurrence rates, and complication rates. 3. Diabetic patients had prolonged healing time compared to those without diabetes, but this trend did not reach statistical significance Takeaway Message: CO2 laser excision is a safe and effective treatment for hidradenitis suppurativa. Recurrence and complication rates did not vary with history of diabetes or smoking.