TY - JOUR
T1 - Ultrasound as a diagnostic and management tool in hidradenitis suppurativa patients: a multicentre study
AU - Martorell, A.
AU - Alfageme Roldán, F.
AU - Vilarrasa Rull, E.
AU - Ruiz-Villaverde, R.
AU - Romaní De Gabriel, J.
AU - García Martínez, F.
AU - Vidal Sarro, D.
AU - Velasco Pastor, M.
AU - Ciudad Blanco, C.
AU - Segura Palacios, J. M.
AU - Rodríguez Bandera, A. I.
AU - Pascual Ramírez, J. C.
AU - Sancho Sánchez, C.
AU - Michelena De Gorosábel, N.
AU - Wortsman, X.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - © 2019 European Academy of Dermatology and Venereology 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.
AB - © 2019 European Academy of Dermatology and Venereology 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.
U2 - 10.1111/jdv.15710
DO - 10.1111/jdv.15710
M3 - Article
C2 - 31124183
ER -