Severe Anemia in Hidradenitis Suppurativa Improved by Colostomy and Surgical Treatment: A Case Report

A 46-year-old male patient had been undergoing treatment for hidradenitis suppurativa for over 10 years and had undergone surgical treatment 9 and 7 years before visiting our hospital and subsequently received only conservative treatment. The patient had a history of diabetes mellitus and was diagnosed with stage III hidradenitis suppurativa according to Hurley's classification. He had scars and fistulas, particularly, on the buttocks, and had severe anemia. This anemia appeared to be associated with bleeding from the lesions and chronic inflammation. A colostomy was performed, which eliminated the need for regular blood transfusions, and his hemoglobin level improved to within normal limits after two-stage excisional surgeries, followed by reconstruction with split-thickness skin grafting. Although colostomy can help manage anemia, a serious complication of hidradenitis suppurativa, aggressive surgical intervention, including colostomy, may be necessary for patients with refractory disease to prevent deterioration of their general condition.