๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Intralesional corticosteroids
Intralesional corticosteroids
In a prospective case series with 36 HS patients, the use of intralesional triamcinolone acetonide 10 mg/mL resulted in significant reduction in physician-assessed erythema, edema, suppuration, and size of the lesion at a 7-day follow-up (Fig. 54-4A and B).15 In addition, a significant reduction in patient-reported pain visual analog scale (VAS) scores occurred after 1 day (VAS from 5.5 to 2.3). Results regarding the recurrence rate have not been reported.
Incision and drainage The results of incision and drainage are rapid but temporary in nature.16,17 One case series with six HS patients reported a recurrence rate of 100% after incision and drainage.22 Therefore, when abscesses recur at exactly the same site, excisional surgery for permanent eradication is indicated.23
Complications
Intralesional injection of triamcinolone could potentially result in atrophic scar formation and hypopigmentation due to collagen and fat atrophy. Systemic effects of soft-tissue corticosteroid injections rarely occur.24 In incision and drainage procedures, puncture of the back wall of the abscess may lead to postoperative bleeding.20
Figure 54-4. (A) Inflammatory nodule in the pubic area before intralesional triamcinolone injection. (B) Result of triamcinolone injection after 7 days.