Treatment of ectopic HS of the lower leg with setons, a case report

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and sinus tracts, typically affecting intertriginous areas. Deroofing is a commonly used surgical intervention but may be associated with significant postoperative pain and prolonged healing. We report a 37-year-old woman with long-standing HS, Hurley stage III, involving typical regions and an atypical, refractory lesion on the left lower leg. After systemic biological treatment and intralesional corticosteroids failed to improve the atypical lesion, setons were used as a minimally invasive alternative resulting in good clinical outcome and a high patient satisfaction. This case report supports a broader implementation of seton placement in HS lesions, providing symptomatic relief and facilitating healing while preserving tissue.