Acne inversa (synonyms: acne triad, acne tetrad or hidradenitis suppurativa, and others) is an inflammatory disease that develops mostly in the axillae, under the breasts and in the anogenital region. The new term, acne inversa, encompasses what was previously called the occlusion triad or tetrad. The disease is relatively common, but the diagnosis is frequently missed. Many different modalities of treatment are recommended in the literature. Radical surgical intervention should be performed at the earliest recognized stage. In the light of experience with our own patients, we propose surgical intervention with wide excision and subsequent healing by secondary intent.