The findings of 18F-fluorodeoxyglucose positron emission tomography–computed tomography scan in patients with hidradenitis suppurativa in Malaysia: A multicenter study

Abstract

Hidradenitis suppurativa (HS) is known to have association with systemic diseases with chronic inflammation such as psoriasis. We aim to describe the concomitant systemic inflammation in patients with HS using 18F-fluorodeoxyglucose positron emission tomography–computed tomography ( 18 F-FDG PET/CT) scan. This was a case–control study conducted in three tertiary hospitals in Northern Malaysia from January to December 2017, involving HS patients aged 18 years and above. Thirty-two HS patients with age- and sex-matched controls were recruited with a mean age of 31.4 years (range: 18–56). Numerous cutaneous inflammatory foci were detected on FDG-PET/CT scan in clinically unapparent sites (27/32, 84.4%). Approximately 90.6%, 93.8%, and 50.0% of the patients had significantly higher cutaneous uptake over nasal, mandibular, and scalp regions, respectively ( P < 0.0001). PET/CT scan did not detect any systemic inflammation unlike those found in psoriasis. Three (9.4%) patients had thyroid nodules with high uptake (maximum standard uptake values ranging from 2.9 to 11.3). Two of them were confirmed to have papillary thyroid carcinoma, while the third patient has inconclusive finding. 18 F-FDG PET/CT scan may be useful to map disease burden of HS. Nonlesional inflammatory foci on the skin of the nose, mandibular, and scalp are probably significant. The association of thyroid carcinoma in HS warrants further evaluation.

The Role of FDG-PET in the Evaluation of Hidradenitis Suppurativa: A Systematic Review

“…This enables clinicians to plan for more effective treatment. Thus, FDG-PET is valuable for the prognostication of HS through its usefulness in mapping disease burden, particularly in subclinical cutaneous sites, as well as for detecting functional changes due to disease that precede anatomical changes [30].…”

“…Fluorodeoxyglucose positron emission tomography (FDG-PET) measures the metabolic activity of the cells in body tissues, allowing for the detection of inflammation, cancer, and infection [30,31]. While FDG-PET imaging is primarily used in the field of oncology, it has proven useful in other medical areas of cardiac and brain imaging.…”