Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study

Martorell, A.; Alfageme, Fernando; Rull, E. Vilarrasa; Ruiz‐Villaverde, Ricardo; Gabriel, J. Romaní de; García‐Martínez, Francisco Javier; Sarró, D. Vidal; Pastor, M. Velasco; Blanco, C. Ciudad; Palacios, J.M.; Bandera, Ana Isabel Rodríguez; Ramírez, José; Sánchez, C; Gorosábel, N. Michelena De; Wortsman, Ximena

doi:10.1111/jdv.15710

Cited by 66 publications

(84 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results are similar to that obtained by a recent Spanish multicentre study comparing clinical vs. US assessment of Hurley staging system in 143 HS patients . With the aid of US, the staging changed to a more severe stage in 44.7% of patients who were diagnosed as having Hurley stage I through clinical examination.…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

Lacarrubba

Dini

Napolitano

et al. 2019

Acad Dermatol Venereol

View full text Add to dashboard Cite

Background Ultrasound (US) is a real‐time non‐invasive technique that has been demonstrated to support an early diagnosis and a more precise assessment of hidradenitis suppurativa (HS). Objectives To compare the clinical and US evaluation of a series of HS patients. Methods 434 HS patients (259 F, 175 M; mean age 33.82 ±13.31 years) observed across 19 Italian dermatology centres [members of the Italian Ultrasound Working Group (IUWG)] were enrolled in a retrospective study. Clinical staging was obtained by the Hidradenitis Suppurativa Physician's Global Assessment score (HS‐PGA), while the ultrasonographic staging was determined by the US HS‐PGA, based on the same scores as clinical HS‐PGA but performed with the aid of US. Results At the end of the study, the mean clinical and US HS‐PGA scores were 2.70 and 2.92, respectively. Direct comparison of clinical and ultrasonographic assessment revealed that a higher proportion of patients was classified as having moderate and very severe disease by US. In particular, 117 patients (26.96%) had a worse classification by US HS‐PGA compared to clinical assessment. Conclusion Our findings confirm that the use of clinical grading only to assess HS severity may underestimate the real disease severity. US examination can be considered an essential non‐invasive imaging tool available to dermatologists for a more accurate diagnosis, staging, treatment planning and monitoring of HS and should be included in the pathway to an optimal standard of care of HS.

show abstract

Section: Discussionsupporting

confidence: 88%

“…US assessment of Hurley staging system in 143 HS patients. 23 With the aid of US, the staging changed to a more severe stage in 44.7% of patients who were diagnosed as having Hurley stage I through clinical examination. In particular, on clinical examinations 26.6% of patients…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

Lacarrubba

Dini

Napolitano

et al. 2019

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…However, according to the literature, the primary lesions detected by ultrasound in HS have been reported to have similar morphologic characteristics in different ethnicities . The study did not compare the performance of the Hurley and SOS systems because of the widely reported underestimation of the severity by the clinical evaluations in HS …”

Section: Discussionmentioning

confidence: 96%

Seventy‐MHz Ultrasound Detection of Early Signs Linked to the Severity, Patterns of Keratin Fragmentation, and Mechanisms of Generation of Collections and Tunnels in Hidradenitis Suppurativa

Wortsman

Calderón

Castro

2019

J of Ultrasound Medicine

Self Cite

View full text Add to dashboard Cite

Objectives-To test the capability of 70-MHz ultrasound for detecting initial ultrasound signs of hidradenitis suppurativa (HS) linked to severity.Methods-A cross-sectional study of the ultrasound images of patients with HS was conducted and compared with a healthy control group. Detection and identification of early subclinical ultrasound signs in the lesional and perilesional areas of the HS cases in comparison with the control group were performed. Statistical analyses included mean, dispersion measures, the Kruskal-Wallis test, and bivariate and multivariate ordered logistic regression studies. Significance was assessed at P < .05.Results-A total of 139 patients with HS met the criteria and showed abnormalities of the hair follicles such as a curved shape, ballooning, and protrusion into pseudocysts, collections, or tunnels (donor of keratin sign). Significant increases in the sizes of the hair follicles and hair shafts were found in HS cases. The following ultrasound signs were significantly linked to severity: a connecting band between the base of adjacent hair follicles (bridge sign), a fragment of the hair shaft extruding through a dilated hair follicle (sword sign), and retained cylindrical fragments of keratin in the dermis. Two patterns of fragmentation of the keratin were detected: multifragment and cylindrical.Conclusions-Ultrasound can detect early HS signs that are significantly linked to severity and 2 types of fragmentation of the keratin, which could support the generation and perpetuation of the fluid collections and tunnels. These ultrasound signs can help prompt diagnosis and management, the development and testing of medications, and the measure of treatment outcomes in HS.

show abstract

“…In a multicenter study ultrasound better assessed hidradenitis suppurativa patients than clinical inspection alone, resulting in upstaging of most patients as a consequence of the identification of occult and deep fistulous tracts, previously considered to be part of an inflammatory nodule [55].…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Position Statement on Dermatologic Ultrasound

et al. 2020

View full text Add to dashboard Cite

Dermatologic ultrasound is a recent application of ultrasound for the evaluation of healthy skin and appendages and their diseases. Although the scientific literature regarding this application is still not sufficient for evidence-based guidelines, general recommendations issued by scientific societies are necessary. The EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) steering committee for dermatologic ultrasound has developed a series of consensus position statements regarding the main fields of dermatologic ultrasound (technical requirement, normal skin and appendages, inflammatory skin diseases, tumoral skin diseases, aesthetic dermatology and practice-training requirements). This document is the foundation for future evidence-based recommendations and guidelines for dermatologic ultrasound practice.

show abstract

Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study

Cited by 66 publications

References 28 publications

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

Seventy‐MHz Ultrasound Detection of Early Signs Linked to the Severity, Patterns of Keratin Fragmentation, and Mechanisms of Generation of Collections and Tunnels in Hidradenitis Suppurativa

European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Position Statement on Dermatologic Ultrasound

Contact Info

Product

Resources

About