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J Eur Acad Dermatol Venereol. 2019 May 24. doi: 10.1111/jdv.15710. [Epub ahead of print]

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

Author information

1
Department of Dermatology, Hospital de Manises, Valencia, Spain.
2
Department of Dermatology, Hospital Puerta de Hierro, Madrid, Spain.
3
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
4
Department of dermatology, Hospital Virgen de las Nieves, Granada, Spain.
5
Department of Dermatology, Hospital Parc Taulí, Sabadell, Spain.
6
Department of Dermatology, Hospital del Sureste, Madrid, Spain.
7
Department of Dermatology, Hospital Sant Joan Despi Moises Broggi, Barcelona, Spain.
8
Department of Dermatology, Hospital Arnau de Vilanova, Valencia, Spain.
9
Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
10
Department of Dermatology, Hospital costa del Sol, Marbella, Spain.
11
Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain.
12
Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain.
13
AbbVie Spain SLU, Madrid, Spain.
14
Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Departments of Dermatology, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.

Abstract

BACKGROUND:

It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS).

OBJECTIVE:

To determine the usefulness of ultrasound as a diagnostic tool in HS compared with clinical examination and to assess the subsequent modification of disease management.

METHODS:

Cross-sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared.

RESULTS:

Of 143 HS patients were included. Clinical examination scored 38, 70 and 35 patients as Hurley stage I, II and III, respectively; with ultrasound examination, 21, 80 and 42 patients were staged with Hurley stage I, II and III disease, respectively (P < 0.01). In patients with stage I classification as determined by clinical examination, 44.7% changed to a more severe stage. Clinical examination indicated that 44.1%, 54.5% and 1.4% of patients would maintain, increase or decrease treatment, respectively. For ultrasound examination, these percentages were 31.5%, 67.1% and 1.4% (P < 0.01). Concordance between clinical and ultrasound intra-rater examination was 22.8% (P < 0.01); intra-rater and inter-rater (radiologist) ultrasound agreement was 94.9% and 81.7%, respectively (P < 0.01).

LIMITATIONS:

The inability to detect lesions that measure ≤0.1 mm or with only epidermal location.

CONCLUSION:

Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.

PMID:
31124183
DOI:
10.1111/jdv.15710

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