WIDE EXCISION
WIDE EXCISION
A “wide excision” is typically indicated in patients with Hurley III disease (Fig. 54-9).
In this section the “wide excision” procedure is interpreted as the resection of the entire affected area, incorporating a ~1.0-cm margin (more extensive compared with the “limited excision”). The difference with a limited excision is based on the size of the affected area: a wide excision encompasses ≥1% of the total BSA, whereas a limited excision is limited to Hurley I-II lesions (<1% BSA). When patients with Hurley III disease are planned for surgery, special attention should be paid to preoperative medical management. Anti-inflammatory therapy, for example, TNF-α inhibitors and/or systemic antibiotics, is recommended to lower disease activity, which potentially might result in less extensive surgery.41,42
Figure 54-9. Hurley III in the right axilla.