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

Abstract

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.

Efficacy and safety of topical resorcinol 15% as long‐term treatment of mild‐to‐moderate hidradenitis suppurativa: a valid alternative to clindamycin in the panorama of antibiotic resistance

“…All included participants applied topical 15% resorcinol (incorporated in an oil/water cream as galenic product) once daily for 12 weeks in inflammatory HS lesions, including subcutaneous nodules, abscesses and sinus tracts. All patients were examined clinically and with ultrasonography at baseline, and at 4 and 12 weeks 4 . Clinical response [according to the Hidradenitis Suppurativa Clinical Response (HiSCR) measure] was achieved in 32 (52%) and 52 (85%) patients after 4 and 12 weeks, respectively ( P < 0·001).…”

Lymecycline vs. clindamycin plus rifampicin in hidradenitis suppurativa treatment: clinical and ultrasonography evaluation

“…Lesions were categorized according to their sonographic morphology, and power Doppler (PD)-US criteria were assessed for diagnosing HS. [12][13][14][15] All sonographic examinations were performed by dermatologists experienced with HS who had completed the same training. In addition, identical equipment (MyLab TM One; Esaote, Genoa, Italy) with a 10-18 MHz linear transducer was used in both centres.…”

Effects of in vivo application of an overnight patch containing Allium cepa , allantoin, and pentaglycan on hypertrophic scars and keloids: Clinical, videocapillaroscopic, and ultrasonographic study

“…It has already been demonstrated that VEGF production is strongly expressed in the keratinocytes overlying keloids 13 . Furthermore, in vitro studies have shown that it is expressed at higher levels in keloid‐derived fibroblasts than in normal skin 9,14 .…”