Sonographic Comparison of Morphologic Characteristics Between Pilonidal Cysts and Hidradenitis Suppurativa

Wortsman, Ximena; Castro, Ariel; Morales, Claudia; Franco, Carmen; Figueroa, Andrés

doi:10.1002/jum.14282

Cited by 27 publications

(28 citation statements)

References 33 publications

(100 reference statements)

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“…Even clear pathological criteria are still warranted. Similar ultrasonographic features have been reported for both HS and PSD, 9 suggesting that distinguishing between IG-HS and PSD can be difficult. The major limitation of our work is the retrospective design of the study, which could be associated with a lack of accuracy in the recorded data.…”

Section: Discussionsupporting

confidence: 74%

“…7 Sharing the initial event of follicular occlusion, HS and PSD are part of the follicular tetrad, along with dissecting cellulitis of the scalp and acne conglobata. 6,9 In the phenotypical classification of Canoui-Poitrine et al, patients with HS classified as LC2 had higher probabilities not only for breast and armpit involvement, but also for involvement of the ears, chest, back or legs and for follicular lesions including PSD. 10 Therefore, these factors raise the question of whether PSD and HS represent a spectrum of one disease or are separate entities.…”

Section: What Does This Study Add?mentioning

confidence: 99%

“…Histology does not always help to distinguish between both entities . Sharing the initial event of follicular occlusion, HS and PSD are part of the follicular tetrad, along with dissecting cellulitis of the scalp and acne conglobata . In the phenotypical classification of Canoui‐Poitrine et al ., patients with HS classified as LC2 had higher probabilities not only for breast and armpit involvement, but also for involvement of the ears, chest, back or legs and for follicular lesions including PSD .…”

mentioning

confidence: 99%

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Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross‐sectional study among 2465 patients

et al. 2019

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Summary Background Hidradenitis suppurativa (HS), also referred to as acne inversa, is a debilitating skin disease characterized by inflammatory nodules, chronic abscesses and tunnels (fistulae and sinuses). The association with pilonidal sinus disease (PSD) is frequently reported but not well documented. Objectives To determine the prevalence and characteristics of inflammatory skin lesions located in the intergluteal fold (IGF) of patients with HS. Methods This was an international multicentre retrospective cross‐sectional study based on data collection from a large cohort of patients with HS with and without histopathology. Results From a total of 2465 patients with HS included in the study, 661 (27%) reported lesions in the IGF. These patients were significantly more often smokers and had more severe HS. Of the 238 patients with an available clinical diagnosis, intergluteal‐HS (IG‐HS) was diagnosed in 52 patients (22%) and PSD was diagnosed in 186 patients (78%). IG‐HS was associated with the localization of HS in the proximity of the IGF, including the buttocks, genitals and the anus. There was a possibility of misclassification bias in this study as a clinical/image‐based diagnosis or histopathology of the IGF lesions was not always available. Conclusions The high prevalence of PSD suggests a strong link between both entities. Therefore, it may be useful to identify common pathophysiological mechanisms and develop common therapeutic strategies. What's already known about this topic? The occurrence of pilonidal sinus disease has not been clearly reported among patients with hidradenitis suppurativa/acne inversa. What does this study add? This is the first study that investigated the prevalence of pilonidal sinus disease among a large cohort of patients and identified the patient characteristics. Risk factors that might help to improve the management of patients were identified.

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Section: Discussionsupporting

confidence: 74%

Section: What Does This Study Add?mentioning

confidence: 99%

mentioning

confidence: 99%

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Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross‐sectional study among 2465 patients

et al. 2019

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“…Because of their submucosal location and nonspecific imaging appearance, BCs are often misdiagnosed preoperatively as other subcutaneous cystic lesions. The most common growths in the differential diagnosis of subcutaneous BCs are pilonidal cysts, dermoid cysts, epidermoid cysts, and cystic hygromas [ 6 , 8 , 9 , 11 , 15 ]. Pilonidal cysts occur predominantly in males.…”

Section: Discussionmentioning

confidence: 99%

Giant subcutaneous bronchogenic cyst in the intergluteal cleft region of an adult: a case report and literature review

Zheng

Huang

2022

BMC Med Imaging

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Background Bronchogenic cysts (BCs) are generally detected in the mediastinum, along the tracheobronchial tree, or in the lung parenchyma. Subcutaneous BCs are rare, but, when found, are usually small (< 3 cm) and detected in children. Case presentation In an unusual adult case, we treated a 52-year-old woman who presented with a mass in the left intergluteal cleft region. Ultrasonography showed a well-circumscribed hypoechoic lesion with posterior enhancement and internal echogenic foci within the mass. Color Doppler images showed no signals. Computed tomography showed the mass as a homogeneous, 6.8- × 6.3- × 5.1-cm soft tissue-attenuation lesion lodged in subcutaneous fatty tissue. Magnetic resonance imaging revealed a cystic lesion of similar dimensions with heterogeneous hyperintensity on both T1- and T2-weighted images. No contrast enhancement, solid components, or restricted diffusion foci were apparent. The cyst was completely excised, and histopathological evaluation indicated it was a BC. The patient’s recovery was uneventful. Conclusions BCs should be considered in the differential diagnosis of all subcutaneous cystic masses, regardless of their location and size and the patient’s age.

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“…10,13,14 It is now widely accepted that the primary drive of disease activity centers upon the follicular infundibulum 13,14 (Figure 1). Additionally, other disorders such as pilonidal sinus disease 15 and dissecting cellulitis of the scalp 16 share many clinical, histological, and inflammatory features with HS [15][16][17] and are beginning to be considered as uni-localized variants of disease. 18 Melnik's seminal 2013 paper 19 began to shift the pathogenic paradigm of HS away from an apocrine-gland-based inflammatory or infectious disorder, to a disorder of follicular occlusion and proposed dysregulated Notch signaling 19,20 as the unifying feature of HS pathogenesis.…”

Section: The Evolving Pathogenic Paradigm Of Hidradenitis Suppurativamentioning

confidence: 99%

The pathogenesis of hidradenitis suppurativa: Evolving paradigms in a complex disease

Kozera

Frew

2022

Dermatological Reviews

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Hidradenitis suppurativa is a complex inflammatory skin disease with the molecular pathogenesis of disease incompletely understood. Recent observational and experimental insights into disease pathogenesis are challenging long-held beliefs regarding the causes and mechanisms of disease. The most effective treatments to date are anti-inflammatory in nature suggesting inflammation is the major driver of disease activity. This study critically evaluates the existing literature regarding the mechanisms of disease pathogenesis. Specifically, it questions the role of follicular occlusion as the central driver of disease activity and reframes hidradenitis suppurativa as a complex autoinflammatory and autoimmune disorder. Ongoing efforts to understand the mechanisms of disease will no doubt lead to more efficacious therapeutics to control this burdensome disabling disease.

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Sonographic Comparison of Morphologic Characteristics Between Pilonidal Cysts and Hidradenitis Suppurativa

Cited by 27 publications

References 33 publications

Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross‐sectional study among 2465 patients

Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross‐sectional study among 2465 patients

Giant subcutaneous bronchogenic cyst in the intergluteal cleft region of an adult: a case report and literature review

The pathogenesis of hidradenitis suppurativa: Evolving paradigms in a complex disease

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