Chronic deep recurrent pyoderma in the outpatient practice of the surgeon

Abstract

Introduction. Chronic deep pyoderma occurs relatively rare in the surgeon practice and, due to the poor knowledge of this pathology, its diagnosis is difficult by surgeons. Misdiagnosis leads to erroneous treatment tactics. Chronic deep recurrent pyoderma includes: abscessing and disrupting perifolliculitis of the head (Hoffmann) (ADPH), axillary and inguinal-perineal suppurative hydradenitis, pilonidal cyst of the sacrococcygeal area. The diseases listed follow the same pathogenesis.

The purpose of the publication: to acquaint surgeons with the diagnosis and treatment of a particular type of chronic deep recurrent pyoderma – abscessing and disrupting head perifolliculitis (Hoffmann) in the conditions of the surgery room, since this problem is purely issued in the literature of the subject.

Material and methods. Since 2007 until to 2020, we had observed 20 cases of deep chronic recurrent pyoderma (15 men and 5 women), but only two cases were correctly detected before treatment, in other cases – retrospectively. Research method: analyzing of clinical observation data and laboratory tests.

Results. In our practice, nine men suffered from abscessing and disrupting perifolliculitis of the head. We had described and classificated the features of this disease, focused on three clinical cases.

Conclusions. Abscessing and disrupting perifolliculitis of the head is still purely diagnosable and curable disease, the treatment as follows: regimen and hygienic measures, surgical treatment, conservative treatment. Surgical treatment should be as radical as possible.