Advanced suppurative hidradenitis resulting from chronic, progressive, inflammatory involvement of apocrine sweat glands often fails to respond to conservative treatment. Extensive surgical excision of all the infected areas with aggressive postoperative wound care in two of three patients provided relief from this debilitating disease. Skin grafting promoted wound healing in addition to improving cosmetic results. Advanced chronic hidradenitis suppurativa of the vulva should be treated with surgery, and conservative management is justifiable only if preparatory to surgical excision.
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