Guía clínica chilena para el estudio y tratamiento de hidradenitis supurativa. Resumen ejecutivo

Reyes‐Baraona, Francisco; Herane, María Isabel; Wortsman, Ximena; Figueroa, Andrés Jiménez; García-Huidobro, Isidora; Giesen, Laura; Kolbach, Marianne; Molina, Marı́a Teresa; Muñoz, Leoncio; Saavedra, Daniela; Silva-Feistner, Marcos

doi:10.4067/s0034-98872021001101620

Cited by 6 publications

(1 citation statement)

References 85 publications

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“…The assessment of severity on ultrasound has been validated in multicentric studies and has shown very good intra and interrater agreements that are much higher compared to some of the widely used classifications of the clinical scorings commonly used in clinical trials. Moreover, the degree of severity detected on ultrasound is a critical finding that frequently causes a modification of the HS treatment 5,6,9–20 …”

Section: Figurementioning

confidence: 99%

Update on Ultrasound Diagnostic Criteria and New Ultrasound Severity and Activity Scorings of Hidradenitis Suppurativa

Wortsman

2023

J of Ultrasound Medicine

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Hidradenitis suppurativa (HS) is a devasting autoimmune cutaneous disease that affects the hair follicles and can clinically present palpable nodules, abscesses, and tunnels (fistulas), usually in the intertriginous regions. It has been widely reported that color Doppler ultrasound can detect subclinical abnormalities and stage the severity of the disease more accurately. Nevertheless, the ultrasound diagnostic criteria were reported with 15 MHz 10 years ago, and now it is possible to detect early anatomical abnormalities in HS using 70 MHz. Thus, an update of the ultrasonographic diagnostic criteria is needed. The most widely used sonographic staging of severity of HS (SOS‐HS) includes the number of affected regions, besides counting the number of key lesions like pseudocysts, fluid collections, and tunnels; however, the total number of affected regions may fit better in an activity scoring. Furthermore, a high number of tunnels or communicated tunnels can complicate the management and may indicate an even more urgent treatment, which should be considered in the severity classification. To date, no hidradenitis scoring of activity has been reported in the literature, making it difficult to track the degree of inflammation under treatment objectively. Therefore, two new scorings are proposed. The first is an updated sonographic scoring of severity called modified SOS‐HS (mSOS‐HS), and the second is an activity ultrasound scoring of HS called US‐HSA. Both staging systems can provide better anatomical information for discriminating the categories and, therefore, selecting more appropriate treatments and supporting research and clinical trials by giving more objective anatomical tools in real‐world settings.

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Section: Figurementioning

confidence: 99%

Update on Ultrasound Diagnostic Criteria and New Ultrasound Severity and Activity Scorings of Hidradenitis Suppurativa

Wortsman

2023

J of Ultrasound Medicine

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Ultrasonography of Facial and Submandibular Hidradenitis Suppurativa and Concomitance with Acne Vulgaris

Wortsman,

Ortiz‐Orellana,

Valderrama

et al. 2024

J of Ultrasound Medicine

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ObjectivesTo describe the ultrasound characteristics of facial and submandibular hidradenitis suppurativa (HS) and detect acne vulgaris (AV) concomitance in these cases.MethodsWe performed a retrospective study of the ultrasound images of patients with facial HS who had been clinically evaluated by dermatologists. The reported ultrasound diagnostic criteria, severity (mSOS‐HS), and activity (US‐HAS) staging of HS were used to categorize the patients. The finding of fragments of hair tracts within the key lesions (dilated hair follicles, pseudocysts, fluid collections, and tunnels) was considered a pivotal sign to discriminate HS from AV. Demographic and morphological analysis of the images were considered.ResultsThirty‐three patients met the criteria (78.8% male/21.2% female). Of these, the mSOS‐ HS scoring was stage I in 51.5%, stage II in 27.3%, and stage III in 21.2%. Dilation of the hair follicles and the presence of pseudocysts, fluid collections, and tunnels were detected in the HS cases; 63.1% of pseudocysts, 62.4% of tunnels, and 46.2% of fluid collections contained fragments of hair tracts. In all HS cases, there was a key lesion(s) with fragments of hair tracts. Four (12.1%) patients showed concomitant facial HS and acne ultrasound lesions. The acne lesions were pseudocysts without inner hair tract fragments in all cases, and the SOS‐Acne scoring was stage II for all of them.ConclusionFacial HS can be detected on ultrasound and shows a morphology similar to that of HS in other corporal regions. In some cases, facial HS could be concomitant with AV. The subclinical ultrasonographic information can support a better management of these cases.

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Role of Color Doppler Ultrasound in Cutaneous Inflammatory Conditions

Wortsman

2024

Seminars in Ultrasound, CT and MRI

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Guía clínica chilena para el estudio y tratamiento de hidradenitis supurativa. Resumen ejecutivo

Cited by 6 publications

References 85 publications

Update on Ultrasound Diagnostic Criteria and New Ultrasound Severity and Activity Scorings of Hidradenitis Suppurativa

Update on Ultrasound Diagnostic Criteria and New Ultrasound Severity and Activity Scorings of Hidradenitis Suppurativa

Ultrasonography of Facial and Submandibular Hidradenitis Suppurativa and Concomitance with Acne Vulgaris

Role of Color Doppler Ultrasound in Cutaneous Inflammatory Conditions

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