Thus, should US imaging be used when the patient accepts surgical procedures? If it is to be put into practice, US imaging first requires for the surgeon to be trained in order to manage US echograph. Then, it would be necessary to determine when this US evaluation has to be performed: at the surgeon's consultation when indication of surgery and surgical methods are decided? In the operating room, after presurgical antibiotics? Of note, Wortsman et al. 3 in both studies described the US images of HS patients comparing them to images of healthy controls or to clinical staging of the same HS patients 4 but neither the temporality nor the pharmacological conditions were specified. Indeed, Caposiena et al. 6 showed the impact of antibiotics in reducing HS lesions highlighted by US imaging. US imaging is a promising tool, but some issues still need to be solved.

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