Strong validation of ultrasound as an imaging biomarker in hidradenitis suppurativa

Wortsman, Ximena

doi:10.1111/bjd.19433

Cited by 14 publications

(12 citation statements)

References 11 publications

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“…On color or power Doppler, it is possible to monitor the degree of inflammation in the dermis and hypodermis; therefore, an ultrasonographic tracking of the activity of the disease 109–111 …”

Section: Advances In Inflammatory Diseasesmentioning

confidence: 99%

“…27,108 On color or power Doppler, it is possible to monitor the degree of inflammation in the dermis and hypodermis; therefore, an ultrasonographic tracking of the activity of the disease. [109][110][111] Thus, ultrasound can solve the problem of the clinical underestimation of the severity of the disease and help correct the staging. The most commonly used ultrasonographic scoring of the severity of HS is the SOS-HS.…”

Section: Advances In Inflammatory Diseasesmentioning

confidence: 99%

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Top Advances in Dermatologic Ultrasound

Wortsman

2022

J of Ultrasound Medicine

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The advances in dermatologic ultrasound have been significantly influenced by the development of high‐ and ultrahigh‐frequency probes, the provision of guidelines for performing the examinations, and a growing number of publications in the field. This review analyzes the most significant contributions that have impacted the daily practice of dermatologists in recent years. This includes the advances in anatomical detection and the patterns of benign and malignant cutaneous tumors, inflammatory dermatologic conditions, vascular anomalies, nail abnormalities, and aesthetic procedures. The knowledge of these advances is a primer for the operators of these examinations.

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Section: Advances In Inflammatory Diseasesmentioning

confidence: 99%

Section: Advances In Inflammatory Diseasesmentioning

confidence: 99%

Top Advances in Dermatologic Ultrasound

Wortsman

2022

J of Ultrasound Medicine

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“…No recurrence of the regressed nodules has been identified after 6 months. Ultrasound allowed a better classification of the inflammatory lesions, confirming the crucial role in the assessment of the disease severity ( 17 , 18 ). However, the abscess showed a favorable response and pseudocystic nodules, and the general appearance of the skin improved in the treated areas.…”

Section: Discussionmentioning

confidence: 54%

Non-surgical treatment of hidradenitis suppurativa: the role of cryotherapy

et al. 2023

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BackgroundHidradenitis suppurativa is a chronic and recurrent inflammatory disease with a great impact on a patient's quality of life, due to the painful involvement of very sensitive areas, such as the groin, mammary area, and genitals, with malodourous discharge. Multiple treatment options are available; however, no single treatment is effective for all patients, and usually, a combination of medical therapy with various surgical and physical procedures is provided. Cryotherapy is not a routine technique to treat HS, although usually available in the majority of medical clinics, and is cheaper than laser and surgical treatments. The aim of this study was to evaluate the effectiveness of cryotherapy on persistent HS nodules, to reduce the burden of local disease.Materials and methodsRetrospective observational study in all patients treated with liquid nitrogen cryotherapy for persistent nodules of hidradenitis suppurativa in the last 2 years, with at least 6 months of follow-up after the procedure. Disease severity was assessed with Hurley staging and sonographic staging according to SOS-HS (18 MHz probe, Esaote-MyLab™). The results were scored with a 0–3 points scale, as complete remission (3), partial response (2 to 1), or no response (0), after one session of treatment. Local cleansing and antiseptic treatment after the procedure was the same as previously performed in each patient, not to influence recovery.ResultsIn total, 23 patients were included, with a total of 71 persistent nodules treated with a single cryotherapy session. The treatment has been effective in 63 out of 71 nodules treated (88.7%), and the patients attested that they recommend the treatment, the discomfort during recovery was minimal, and the management was not different from daily routine. Persistence was considered as having a failure rate (11.3% overall) and occurred in 7.5% of the nodules of the axillary region, 18.2% on the groin, and 11.2% for nodules of the gluteal region.ConclusionCryotherapy is a simple and effective procedure for the treatment of persistent nodules of HS not responding to medical therapy, and it is a valid alternative to local surgery or laser ablation.

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“…2 Diagnosis and follow-up are based on ultrasound, which can provide early detection of structural abnormalities, more accurate staging, and tracking of the degree of activity. 3 International Hidradenitis Suppurativa Severity Score System (IHS4) is a validated tool to dynamically assess HS severity. It is calculated by the sum of the number of nodules (multiplied by 1), the number of abscesses (multiplied by 2), and the number of draining tunnels (multiplied by 4).…”

Section: Introductionmentioning

confidence: 99%

“…Factors such as heat, sweating, shaving, and friction exacerbate symptoms 2 . Diagnosis and follow‐up are based on ultrasound, which can provide early detection of structural abnormalities, more accurate staging, and tracking of the degree of activity 3 …”

Section: Introductionmentioning

confidence: 99%

Azathioprine in hidradenitis suppurativa with inflammatory phenotype: a case series of 11 patients

López Riquelme,

Fernández Ballesteros,

Perea Polak

et al. 2023

Int J Dermatology

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BackgroundHidradenitis suppurativa (HS) is a chronic inflammatory disease that negatively impacts the quality of life of patients. It presents as deep‐seated nodules, abscesses, fistulae, sinus tracts, and scars in the axilla, inguinal area, submammary folds, and perianal area. Recently, two phenotypes have been described: a follicular phenotype and an inflammatory phenotype. Numerous medical treatments are available for hidradenitis suppurativa, with particular importance of antitumor necrosis factor antibodies. Due to the association of HS with other conditions with a pro‐inflammatory state, particularly Crohn's disease, it has been suggested that azathioprine may have a role in the treatment of HS.ObjectiveTo assess the effectiveness of azathioprine monotherapy in patients with moderate‐severe HS.MethodsWe retrospectively studied patients with HS treated with azathioprine in monotherapy. We performed both clinical and ultrasound evaluation at baseline as well as in the follow‐up visits. Their baseline score on the iHS4 and DLQI scales and 12–16 weeks after starting the treatment were compared. We also registered the number of patients who achieved HiSCR.ResultsSix patients presented significant improvement, reducing their score in iHS4 and DLQI scales and achieving HiSCR. Another patient had clinical improvement, meaning reduction in iHS4 and DLQI, but without achieving HiSCR. Two patients stopped the treatment before week 12 because of adverse events. The remaining two patients presented no improvement. The median (Q3–Q1) baseline iHS4 score was 6 (12–6), and follow‐up iHS4 score, 4 (6–2), being these differences statistically significant (P = 0.006). Median (Q3–Q1) baseline DLQI scores and 12–16 weeks after treatment were 17 (23–11) and 14 (18–9), although statistically nonsignificant (P = 0.099).ConclusionWe present a case series of 11 patients treated with azathioprine with good clinical and ultrasonographic response. We suggest that azathioprine may benefit a certain patient profile with the inflammatory phenotype.

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Strong validation of ultrasound as an imaging biomarker in hidradenitis suppurativa

Abstract: Linked Article: Grand et al. Br J Dermatol 2021; 184:688–696.

Cited by 14 publications

References 11 publications

Top Advances in Dermatologic Ultrasound

Top Advances in Dermatologic Ultrasound

Non-surgical treatment of hidradenitis suppurativa: the role of cryotherapy

Azathioprine in hidradenitis suppurativa with inflammatory phenotype: a case series of 11 patients

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