Recurrence of Acne inversa of the penis - two-stage reconstruction with MatriDerm® and split-thickness skin graft.

Background: The authors report a case of a 42-year-old male patient who presented with a relapse of penile acne inversa five years after a split-thickness skin graft without use of collagen-elastin-matrix (CEM). After unsatisfactory pharmacological treatment, resection of the affected skin, negative pressure wound therapy (NPWT), CEM application, and split-thickness skin graft (STSG) were performed in several steps. Methods: We performed initial debridement and consecutive NPWT. After achieving a clean wound bed, a CEM (1 mm MatriDerm®; MedSkin Solutions Dr. Suwelack AG, Germany) was applied, followed by split-thickness skin grafting. Results: During a 19-month follow-up, the patient presented with a very good functional and cosmetic outcome. Under intravenous antibiotic therapy and intensive wound care, we achieved complete recurrence-free status in the genital area at the 19-month follow-up. The subjective quality of life almost tripled from 3.2 to 9.3 on the numeric analog scale (NAS). Conclusion: Complex reconstruction procedures of penile defects in acne inversa can be avoided if there is a well-perfused wound bed. Coverage of the defect with MatriDerm® and split-thickness skin grafting may lead to long-term aesthetically satisfactory results with high patient satisfaction. We have monitored one patient over 19 months, who presented with stable penile soft tissue coverage and no signs of relapse. We anticipate that coverage of penile defects using MatriDerm® and split-thickness skin grafts may prevent or at least delay the need for complex reconstruction in cases of recurrence.