Buyukasik Oktay, Osmanoglu C Gokhan, Polat Yilmaz, Kargici Hulagu, Kaya Gulay
Ministery of Health Ankara Diskapi Training and Research Hospital, General Surgery Clinic, Ankara, Turkey.
MedGenMed. 2005 Oct 20;7(4):19.
The patient was a 38-year-old man. He had been suffering from hidradenitis suppurativa (HS) for approximately 20 years. He had active lesions at both axillas, hip, scrotum, and perineum, and inactive lesions located behind the ears, lower abdomen, and posterior neck. He was monitored and treated at different branches; he continuously used antibiotics and was given steroids at times. Antibiotic resistance developed subsequently. His general situation was bad; vital signs were poor; and he was in a state of sepsis and preshock, so this case was regarded as life-threatening. Total excision was performed first on the lesion at the right axilla, then on the lesion at the left axilla, and the parascapular fasciocutaneous flap was reversed. A skin graft was applied to the triangular defect on the scapula. No relapse occurred. Then the lesions at the hip were managed. Broad excision was used twice with the patient under general anesthesia; because the lesions spread to the retrococcygeal and gluteal muscles, coccyx resection and partial gluteal muscle resection were implemented. The defect was eliminated with a progressive flap. At the intergluteal sulcus, small lesions emerging at the median line were debrided with the patient under local anesthesia, and together with secondary recovery, the disease was completely managed. Lesions at the perineum and scrotum and at both inguinal areas were broadly excised and grafted. No lesion has relapsed so far. One year later, Hodgkin's lymphoma was diagnosed, and the patient was treated with chemoradiotherapy easily, because there was no infective focus. The disease is in remission now. The patient weighs 110 kg, is healthy, and is working again.
患者为一名38岁男性。他患化脓性汗腺炎（HS）约20年。双侧腋窝、臀部、阴囊和会阴有活动性病变，耳后、下腹部和后颈部有非活动性病变。他在不同科室接受监测和治疗；持续使用抗生素，有时还使用类固醇。随后出现了抗生素耐药性。他的一般情况很差；生命体征不佳；处于败血症和休克前期状态，因此该病例被视为危及生命。首先对右侧腋窝的病变进行了彻底切除，然后对左侧腋窝的病变进行了切除，并翻转了肩胛旁筋膜皮瓣。对肩胛骨上的三角形缺损进行了植皮。未发生复发。然后处理臀部的病变。在全身麻醉下对患者进行了两次广泛切除；由于病变蔓延至尾骨后和臀肌，实施了尾骨切除和部分臀肌切除。用推进皮瓣消除了缺损。在臀间沟，在局部麻醉下对患者中线处出现的小病变进行了清创，并随着二期愈合，疾病得到了彻底控制。会阴部、阴囊和双侧腹股沟区的病变进行了广泛切除并植皮。迄今为止，没有病变复发。一年后，诊断出霍奇金淋巴瘤，由于没有感染灶，患者轻松接受了放化疗。目前疾病处于缓解期。患者体重110公斤，身体健康，再次开始工作。
