Whenever there is more than one therapy available for a particular ailment, it is often suspected that none of them is universally effective. There is definitely scope for improving the physical and surgical methods for treating hi-dradenitis suppurativa (HS). The rationale for physical therapies in the later stages of disease is strong. After the formation of sinus tracts it is unlikely that pharmacological treatment can achieve the desired therapeutic effect, unless specific biological targets can be found in the epithelial tissue lining the sinus tracts. The treatment options for Hurley Stage III and unresponsive Stage II disease are therefore currently restricted to physical destruction of the diseased tissue using different treatment modalities . A series of physical therapies have been suggested (see Table 24.1).
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