Clinical cases
Verneuil’s disease clinical, evolutiv and therapeutic aspects of four clinical cases

Verneuil’s disease (VD) is a recurrent, chronic,inflammatory disorder, which manifests as painful, suppurating lesions, located to the regions with abundent sweat or sebaceous glands.

Patients and Methods
We present four cases with VD, men, between 21 and 62 years old, with a case history ranging between 1 and 7 years. Co-morbidities seen in these cases were: acne conglobata (2 cases), pyoderma gangrenosum (1 case) and
metabolic syndrome (1 case). Three patients had stage II VD , with the fourth case allotted to stage III, according Hurley’s classification.
The flare in each case was controlled by long term systemic antibiotherapy and local treatment. Two patients continued with Isotretinoin, but in one of them treatment failure was recorded, leading to the surgical excision with dermoplasty in a specialized department.

Incidence of VD is 1:600 in Caucasians but higher in population of African descent.
Women are more frequently affected than men (F/M=3/1)
The etiopathogenesis is not completely elucidated and the treatment of VD is not standardized.

VD is a chronic disease with important psychological impact, sometimes becoming debilitating.
Therapeutic response to long term systemic antibiotics is good, but this treatment is not curative.
Smoking cessation is mandatory, as well as weight loss in obese patients with VD.
Although multiple therapies became available in the last few years, the basic treatment of BV remains the surgical one. However, surgery is difficult to perform and hard to accept by the patients, especially in extended forms of VD requiring wide excisions.