Punch debridement (mini-deroofing): An in-office surgical option for hidradenitis suppurativa

Deroofing is an in-office technique for hidradenitis suppurativa that is typically locally curative for the specific lesion treated. It is a superior option over incision and drainage, due to lower recurrence rates (100% for incision and drainage vs 4%-19% for deroofing), minimal complications, and high patient satisfaction.1 Conventional deroofing typically entails administering local anesthesia, removing the roof of each abscess/tunnel and exposing all interconnected cavities using scalpel, scissors, electrosurgery, or a CO2 laser.