Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Surgical treatment of postauricular hidradenitis suppurativa with delayed diagnosis: a case report and literature review

  • Inho Kang (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Gyu Yong Jung (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Min Jun Yong (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Yujin Ahn (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Joon Ho Lee (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine)
  • Received : 2023.03.16
  • Accepted : 2023.04.06
  • Published : 2023.04.20
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Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory condition that is difficult to diagnose, with a period of 10.0±9.6 years from symptom onset to diagnosis. A 32-year-old Asian man presented with bilateral postauricular abscesses that first appeared 5 years previously. Despite several incisions and drainage, the symptoms only temporarily improved and continued to recur. On physical examination, chronic scars and sinus tracts were observed around the lesion. Postauricular HS was diagnosed, and surgical treatment was performed. We performed a wide excision and reconstructed the defect using a posterior auricular artery perforator-based keystone flap. Histological examination confirmed the diagnosis of HS. The reconstruction was successful, and there was no recurrence for 2 years after surgery. HS is difficult to diagnose without specific attention. Although the postauricular region is not a typical site of HS, it can occur in this area. Therefore, if a patient presents with recurrent abscesses in the postauricular region, HS should be considered. Additionally, if HS is diagnosed in the postauricular region, wide excision with reconstruction using a posterior auricular artery perforator-based keystone flap can lead to a favorable outcome.

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References

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