Elsevier

Dermatologic Clinics

Volume 34, Issue 1, January 2016, Pages 59-68
Dermatologic Clinics

Imaging of Hidradenitis Suppurativa

https://doi.org/10.1016/j.det.2015.08.003Get rights and content

Section snippets

Key points

  • Clinical examination alone can underestimate the severity of HS.

  • Color Doppler ultrasound may support the management of hidradenitis suppurativa.

  • Sonographic criteria for supporting the diagnosis are established.

  • Disease staging is possible using ultrasound.

  • MRI can help in the diagnosis of extensive and deep anogenital lesions.

Videos of Power Doppler and gray scale ultrasound accompany this article at http://www.derm.theclinics.com/

Ultrasound

This is an imaging modality based on the propagation and return of sound waves in different tissues.9 Ultrasound is a real-time and safe imaging method without reported adverse reactions. Usually, it does not require intravenous injection of contrast media and allows a rich and live interaction between the sonographer and patient.7, 8 The structures or tissues can be classified according to their echogenicity pattern into anechoic (ie, fluid-filled structures that allow the passage of the sound

MRI

This imaging modality relies on the exposure of tissues to a magnetic field. It provides a good definition of the hypodermis and deeper layers and allows examinations of the whole body.21, 22 Nevertheless, in the commercially available units the resolution for observing cutaneous layers is usually low and requires confinement of the patient to a reduced space during the examination. Also, intravenous contrast media is commonly injected, which may be the subject of potential adverse reactions.

Summary

Clinical examination alone can underestimate the severity of HS. Imaging, particularly color Doppler ultrasound, seems to be a powerful tool and the first imaging modality for supporting an early and more precise diagnosis and staging of severity in HS. Additionally, because of the provision of detailed and objective anatomic data, imaging may help in the assessment of the pathogenesis of this complex disease and contribute to clinical trials.

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    Disclosures: None.

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