Post-Surgical Recurrence of Hidradenitis Suppurativa: Key Risk Factors and Predictive Insights Publisher



Rahimnia A ; Sadeghi B ; Ehsani A ; Mohammadabadi MK ; Nikou M ; Ehsani A
Source: Iranian Journal of Dermatology Published:2025

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic dermatological condition of uncertain etiology, high recurrence rates, and significant impacts on quality of life. Surgical treatment is commonly employed; however, recurrence remains a major concern. This study investigated the recurrence rates and factors influencing recurrence following surgical intervention in patients with HS. Methods: This retrospective study analyzed patients diagnosed with HS who underwent surgical treatment at Razi Hospital in Tehran during 2022 and 2023. Data on demographics, clinical features, surgical techniques, and recurrence rates were collected. Recurrence was defined as the reappearance of lesions at the same or different anatomical sites during follow-up. Results: Among 18 patients, the mean age was 31 ± 10.8 years, and 65% were men. The mean body mass index (BMI) was 31 ± 7.5. The axilla was the most commonly affected site. The overall recurrence rate was 27.7%, with significantly higher recurrence rates in the perineum and breast (100%) compared to the axilla (16.7%) (P = 0.018). Women exhibited a higher recurrence rate (57%) than men (9.1%) (P = 0.025). The highest recurrence rate (45%) occurred in the 20–40 age group (P = 0.047). Prior surgery at the same site was associated with a 75% recurrence rate (P = 0.021). Patients from outside Tehran had significantly higher recurrence rates (P = 0.001). Logistic regression identified female sex as a significant predictor (P = 0.046), with a 13-fold increased risk. Conclusion: Recurrence of HS after surgery is common, particularly in women, in non-axillary regions, and in patients with a history of prior surgery. Multidisciplinary management, including weight reduction and biologic therapies, is essential for optimizing outcomes in severe cases. ©Iranian Journal of Dermatology.