Abstract
Pyodermia fistulans sinifica is a relatively rare disease characterized by recurrent abscesses of the apocrine glands in the anogenital areas and less frequently - in these glands in axillary or mammary areas in women. It affects predominantly young men and brings a lot of problems concerning early diagnosis and radical treatment. The course of disease is chronic with frequent recurrences. As a result in the affected areas multiple subcutaneous fistula tracts and chronic suppurative focuses are formed. The main feature of the condition is a wide scar formation in the affected area and chronic puss discharge with an unpleasant odor which gradually leads to disability and a general deterioration in the quality of life. Even today, the exact etiology remains unknown. There is a definite genetic predisposition. The smoking is a trigger factor, while the obesity aggravates the course of the disease. Information about the condition is scarce and disease is often misdiagnosed. This leads to improper treatment tactics, many exacerbations and recurrences. Treatment depends on stage of disease and includes antibiotics, anti-estrogens or androgens and retinoids. In recent years there have been reports on the use of monoclonal antibodies - anti-TNF. Surgical treatment may be limited to incisions with subsequent local excisions. Unfortunately most of the patients usually came into specialized colorectal departments with advanced disease. Then total excision to the underlying fascia followed by secondary wound healing and/or plastic reconstructive operations in the perineal area with flaps or free skin plastics are the only options for radical cure in advanced cases.
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