Cases from the Cornfields: Pearls from the Midwest!

Elizabeth Cusick, a dermatologist and surgeon from the University of Iowa, discusses hidradenitis suppurativa, a chronic inflammatory skin disease, with an emphasis on surgical treatment options for patients. She presents a case of a 50-year-old woman with extensive hidradenitis who has tried numerous medical treatments without success and seeks surgical relief. Cusick outlines the challenges of managing the condition, including the importance of a multidisciplinary approach. She details the patient's history, treatment attempts, and the surgeries she underwent, emphasizing wide local excision as a preferred method due to its lower recurrence rates compared to other treatments. The presentation also covers surgical techniques, wound care, recovery expectations, and the need to optimize patients' health before surgery. Cusick highlights the significance of patient education regarding postoperative care and pain management. She concludes by noting that while recurrence rates are crucial, factors such as quality of life and the aesthetic outcome play significant roles in patient satisfaction. Overall, she underscores the necessity and privilege of providing effective treatment for these challenging cases.